Friday, November 20, 2009

Fight Continues to Save IHSS

460,000 individuals across California rely on in-home supportive services (IHSS). Sadly, some of them will face real life or death situations because of the administration’s ongoing assault on the program.

Last May, the governor proposed to help close our state’s historic budget deficit by reducing IHSS caseloads by 90%. Had we adopted it, this proposal would have returned seniors to nursing homes and institutionalized disabled individuals. Such treatment of our seniors and disabled Californians is not only inhumane and in conflict with public policy in this state for the past several decades, but it is many times more costly than in-home care. The Legislature, therefore, rejected the governor’s proposal.

In subsequent Big 5 negotiations, however, the governor demanded changes in law to address what he considered fraud in the IHSS system. As part of the final budget deal, he demanded substantial changes to the enrollment process for new IHSS providers and anti-fraud requirements, such as fingerprinting, for recipients of IHSS. At the governor’s request, these changes were to be implemented on November 1, 2009.

But the administration has severely botched implementation of these changes. Here is what we know:
• The Department of Social Services (DSS) has been giving counties – who implement the IHSS program—incomplete, incorrect and conflicting information about the new IHSS laws that took effect on November 1;
• The “final” and still incomplete guidance issued to counties detailing how to comply with the law was issued by DSS at 10:21pm on Saturday, October 31;
• Counties have not been provided the necessary materials and resources to meet the new IHSS requirements – such as background checks on in-home care workers;
• 28 counties representing 86% of the IHSS caseload indicated that they will have difficulty meeting the requirements imposed by DSS;
• Without action, IHSS providers may not be able to provide services to clients already enrolled in and eligible for IHSS; and
• Numerous seniors and disabled individuals throughout the state have been unable to obtain the IHSS services they need, at risk to their safety, their well-being, and in some cases, to their very lives.

On October 28, I held an Assembly Budget Committee hearing on the chaos that resulted from the incomplete and conflicting guidance provided by DSS. Counties testified that they had been unable to meet the deadlines set by legislation because of their inability to obtain guidance and resources to implement the IHSS changes. Nevertheless, DSS testified that as of November 1, it would not be paying any new providers for their services. This meant that many IHSS recipients would go without care.

I crafted emergency legislation, Senate Bill (SB) 69, to help clear up this mess. It was a simple bill, requiring DSS to convene a stakeholder process prior to implementing any changes to IHSS. It also delayed implementation of such changes until 60 days after the stakeholder process completed so that counties as well as IHSS clients and providers had time to prepare.

SB 69 required a two-thirds vote of the Legislature because it included an urgency clause so that it could take effect immediately. SB 69 easily passed the Assembly with a unanimous 68-0 vote on November 2. However, working with the administration, Senate Republicans withheld their votes and killed SB 69. I suspect the letter of opposition circulated by DSS to each Senator (enclosed below) had something to do with that. This opposition was unexpected, especially since I crafted the bill based on testimony provided by John Wagner, Director of DSS at my October hearing.

Subsequently, on November 5, I held a second hearing to determine what, if anything, the administration had done to clear up the chaos it had caused in IHSS. The administration effectively thumbed its nose at the Legislature and at the many IHSS recipients in need of services because the Secretary of Health and Human Services and the Director of DSS refused to attend the hearing. I can only conclude that the governor is satisfied with the way his administration has handled these changes to IHSS.

DSS has a history of cooperating with the counties and implementing complex changes in an orderly and professional fashion, sometimes even delaying implementation past the deadline set in statute. The focus has been on getting it right and preventing lapses in service. Why DSS has departed from its stellar record is baffling. It appears that the governor intends to achieve his desired cuts to IHSS indirectly through so-called “reform.”

Until the problems plaguing IHSS are resolved, I will keep pressing every avenue available to me to find a solution. There is real suffering, pain, fear, and even death if we fail to come together and act for the common good.