4. How would collective bargaining in each of California 's 58 counties be managed if program administration were moved to the state level? Currently, IHSS workers, through their representatives, negotiate labor agreements with local IHSS employers of record, generally Public Authorities. Each county Public Authority negotiates a separate agreement with different wages that currently range from an average of $8.50 per hour to $10.60 per hour, plus benefit structures that include health and sometimes vision, dental, holidays, sick leave and pension. Individual contracts or Memorandums of Understanding extend over varying periods of time. The collective bargaining process and resulting improvement in wages and benefits has been credited with helping to stabilize the IHSS workforce , attract and retain more qualified providers and reduce the high turnover rates that threatened care and jeopardized the health of many severely impaired individuals. How will the collective bargaining process and labor relations be conducted under a state administration of the IHSS program?
5. How would the Governor's Quality Assurance Initiative be affected and administered? A most critical issue is standards of care for IHSS clients. The current standards, now carried in MPP 30-700 et seq. , are undergoing major review on a compressed time schedule as required in SB 1103, the 2004-05 Health & Human Services budget trailer bill. How will this review be integrated with the proposed changes and what entity at the local level will be responsible for implementing the initiatives and evaluating their effectiveness?
CDSS has projected savings in 2004-05 from these reforms at only 2% of the total cost because of the need for new standards, training and rules.4 After new rules are in place, the Administration indicated, savings would be at least 10% and as much as 25% .5
Do these projections remain valid?
6. Where should responsibility for client assessments be located? Decisions regarding the responsibility for IHSS client assessments under the new administrative structure can be made after the shape of the new system is clearer. Assessments are currently made by county staff, employed by local social service departments, using state guidelines. Does the proposal envision state staff, who are generally further removed from the actual delivery of services, assuming this function? What impact will this proposal have on current county and state employees?
7. What is the actual fiscal impact of the proposed shift to state administration? CPR projects a savings of $543 million to counties and an additional like amount of cost to the state.
(a) The 2004-05 California budget lists the county share for client hours alone as $578.5 million in the 2004-05 year. These funds are part of the Realignment Trust Fund, which allocates 24.33% of VLF funds and ½ cent of the state sales tax to fund the county share of seven county programs. As these funds are collected by the state and redirected via the VLF to the counties, would the realignment statute be changed to exclude the IHSS portion? The mechanism for severing the fraction devoted to IHSS is unclear.
(b) In addition to the federal, state and local costs for IHSS workers, there are major county and state costs, which would (initially, at least) increase while the shift is being made. It is unclear what these costs would be.
(c) The shift in IHSS is part of the total package of proposals that CPR makes with regard to the counties. The net effect of these shifts would need to be articulated before the total impact could be assessed.
8. What would happen to the dollars owed to counties in realignment funds to compensate for IHSS costs? Realignment funds for seven different programs, including IHSS, are owed to the county to pay back funds for previous years. The 2002-03 shortfall for IHSS caseload growth was nearly $80 million alone.6 Counties are expecting that these funds will be returned. How will the shift in administration of the IHSS program resolve this situation?
The foregoing are major deliberations to make during consideration of these IHSS program reforms. All stakeholders, not just governmental entities, must participate in the process. The Governor's working group must involve a wider, representative net to ensure a balanced, comprehensive and effective process.7
In closing, UDW commends the Governor and members of the California Performance Review Team for their effort towards achieving a more effective government. That is certainly a goal in which we can all share. We look forward to working with them further as these proposals are analyzed and deliberated.
