There is no increased cost to the County General Fund associated with Recommended Action. The County Maintenance of Effort (MOE) share of cost for IHSS administration and Public Authority services was established as part of the State Budget Act of 2012, SB 1008 and SB 1036, and is based on FY 2012 expenditures. Santa Clara’s preliminary final MOE for IHSS administration is $2,178,032.00 and for Public Authority is $134,721.00. County cost in excess of the established MOE will be paid to the County as federal revenue and state revenue or state expense reimbursement.
In FY 2014, the Agency is requesting approval to increase revenue and expenditures by $589,813.00 and to add twenty four (24.0) positions and Object 2 – Services and Supplies funds associated with IHSS Public Authority services. The ongoing increased cost associated with the Recommended Action is $3,381,040.00 with $3,381,040.00 in revenue, and no net increased cost to the County General Fund.
The Agency is requesting approval to amend the FY 2014 Agreement with Sourcewise for IHSS Public Authority (PA) service from the current funding level of $1,055,472.00 to $1,138,107.00, or an increase of $82,635.00. The ongoing amended Agreement funding level will be an annual maximum of $1,307,820.00, or an increase of $252,348.00 above the current funding level.
Currently, any PA cost increases above the MOE base would be covered by state and federal funds. However, the state is considering possible legislative clarification that would result in a50/50 county and federal cost participation only for increased cost above the MOE. Under this possible scenario, the FY 2014 net increased cost to the County General Fund would be $41,318.00 or 50% of $82,635.00, and the ongoing increased cost to the County would be $126,174.00 or 50% of $252,348.00.
Sourcewise, formerly known as Council on Aging Silicon Valley (COA), has provided IHSS Public Authority management services for the County of Santa Clara since May 1999.
· In May 1999, the original agreement between the Public Authority Governing Board and the Council on Aging to provide management services through June 30, 2000 was executed.
· In June 2000, the Public Authority Governing Board approved the first amendment extending the term of the contract through September 30, 2000.
· In September 2000, a second amendment was executed for an additional extension through June 30, 2001, and to provide for expanded services for health benefits administration.
· In June 2001, the Public Authority Governing Board approved a third amendment to the agreement extending the term through June 30, 2002.
· In June 2002, the Public Authority Governing Board authorized a sole source agreement with the Council on Aging for a one-year period through June 30, 2003.
· In June 2003, the Public Authority Governing Board again authorized a sole source agreement with the contractor the following year through June 30, 2004.
· In June 2004, the Public Authority Governing Board approved a delegation of authority authorizing the County Executive or designee to negotiate, execute, and amend an Agreement with the COA which resulted in management services agreements for FY 2005 and FY 2006.
· In June 2006, the Public Authority Governing Board approved a delegation of authority authorizing the County Executive to negotiate, execute, and amend an Agreement with the COA which resulted in three subsequent management services agreements for FY 2007, FY 2008, and FY 2009.
· In June 2009, the Public Authority Governing Board approved a delegation of authority authorizing the County Executive to negotiate, execute, and amend an Agreement with the COA which resulted in three subsequent management services agreements for FY 2010, FY 2011, and FY 2012.
· In May 2012, the Board approved the approved the delegation of authority via the Master Contract List authorizing the County Executive to negotiate, execute, and amend an Agreement with the Council on Aging Silicon Valley which resulted in one subsequent management services agreement for FY 2013.
· In June 2013, the Board approved the Agreement with COA in an amount not to exceed $1,055,472.00 for management services in FY 2014.
REASONS FOR RECOMMENDATION
The Agency is requesting approval to add twenty four (24.0) positions, Object 2 – Services & Supplies funding, and associated revenue and expenditure appropriation. The cost for the remainder of FY 2014 is $589,813.00 with $589,813.00 in federal revenue and state revenue/expense reimbursement. The ongoing cost is $3,381,040.00 with $3,381,040.00 in federal revenue and state revenue/expense reimbursement. Based on current state legislation related to IHSS county share of cost, there is no known increased cost to the County General Fund associated with the Recommended Action. However, possible changes to the state’s interpretation of Public Authority expenses could potentially increase the County share of cost related to Public Authority expenses.
a. IHSS Program
The Agency is requesting approval to add twenty-one (21.0) positions within IHSS Program operations, two Social Work Supervisors positions, sixteen Social Worker II/I positions, and three Data Office Specialist positions. The cost for the remainder of FY 2014 for the requested positions is $428,947.00, with $428,947.00 in federal revenue and state revenue/expense reimbursement, and no net increased cost to the County General Fund. The ongoing cost associated with the Recommended Action is $2,642,766.00 with $2,642,766.00 in federal revenue and state revenue/expense reimbursement, and no increased cost to the County General Fund.
The Agency is requesting approval to add sixteen Social Worker II/I positions and two Social Work Supervisor positions and will create two new caseworker units, with caseload averages of 250 cases per Social Worker. The staffing request is an estimate based on IHSS growth indicators of additional 2,131 cases per year, and program growth trends during the five month period May 2013 through October 2013. The requested staffing will provide the required support for the mandated program. The growth projections is considered a conservative estimate due to the potential influx of new recipients related to Coordinated Care Initiative (CCI) and new recipients qualified through Modified Adjusted Gross Income (MAGI) Medi-Cal.
The three Data Office Specialists positions requested will process incoming documents for provider management and payroll, and provide critical support to Social Workers that require assistance while in the field conducting reassessments.
b. IHSS Finance
The Agency is requesting approval to add two positions within IHSS Finance operations, one alternately staffed Senior Financial Analyst/Financial Analyst II/Financial Analyst I position, and one alternately staffed Accountant III/II/Accountant/Auditor-Appraiser position. The cost for the remainder of FY 2014 for the requested positions is $46,854.00, with $46,854.00 in federal revenue and state revenue/expense reimbursement, and no increased cost to the County General Fund. The ongoing cost associated with the Recommended Action is $294,707.00 with $294,707.00 in federal revenue and state revenue/expense reimbursement, and no increased cost to the County General Fund.
In FY 2013, the IHSS accounting functions were transferred from the Office of Budget & Analysis to Financial Management Services (FMS). At that time, one Senior Accountant position was added in FMS to perform the IHSS accounting duties of claiming, revenue reimbursement, and state invoicing activities. The Senior Accountant position does not have the capacity and bandwidth, nor does the Senior Accountant job classification include the non-accounting duties which are required to manage the IHSS Finance Unit for the County-wide IHSS Program.
It is critical that the Senior Financial Analyst position be added to manage the IHSS Finance operation including:
· Managing the IHSS Finance Unit
· Managing state and federal legislation proposals and changes
· Representing the Agency on various state IHSS committees related to IHSS Finance
· Overseeing financial and legislative functions, developing policies and procedures based on proposed and actual legislative changes
· Developing proposals and financial cost models for IHSS Provider wage, benefits, and administrative expenses other expenses impacts
· Serving as IHSS Finance lead and representative for various County and state executives and senior managers, Public Authority, and state and federal representatives to develop program strategies and approaches
The Agency is requesting to add one alternately staffed Accountant III/Accountant II/Accountant Auditor-Appraiser position to perform the accounting workload resulting from the new State funding model, Maintenance of Effort (MOE), that requires significant accounting above and beyond the former IHSS model, process and reconcile invoices from the State and Public Authority, process fund transfers for intra-county expenditures related to County Counsel and Employee Services Agency, and communicate and follow up with the state to correct state accounting errors. The current Senior Accountant cannot perform all of these accounting tasks while simultaneously developing expense and revenue reimbursement claims, managing budgetary accounting transactions, developing and implementing new accounting procedures and structures to manage the changes in State IHSS provider wage overpayments and collections, and developing and tracking financial and accounting projections and impact associated with various county, state, and federal program changes (i.e. SEIU Labor Contract changes, Coordinated Care Initiative and Dual Eligibility changes, impact of Affordable Care Act, State IHSS MOE, IHSS Wage Overpayment accounting changes, etc.).
c. IHSS Information Systems
The Agency is requesting approval to add one alternately staffed Information Systems Manager II/I position within SSA Information Systems. The cost for the remainder of FY 2014 for the requested position is $31,377.00, with $31,377.00 in federal revenue and state revenue/expense reimbursement, and no increased cost to the County General Fund. The ongoing cost associated with the Recommended Action is $191,219.00 with $191,219.00 in federal revenue and state revenue/expense reimbursement, and no increased cost to the County General Fund.
SSA Information Systems (SSAIS) provides the IHSS with critical software applications, phone services, and data analysis. SSAIS will provide IHSS with development of applications and technical expertise for IHSS to meet client/provider services such as dedicated expertise with the State Case Management System (CMIPS II), Automated Phone System, and data analysis (Data Warehouse). In light of the expanding aging community there is an urgent need for technical staff to provide expertise and assistance in all phases in the use and implementation of mobile applications and equipment to provide tools for the Social Workers to assess their clients’ daily activities in the areas of feeding, bathing, dressing, housekeeping, laundry, shipping, meal preparation, personal hygiene and medical needs while on site. SSA IS will be providing the resources to implement the ability to capture this information while the Social Worker is with the client.
d. IHSS Public Authority – Sourcewise
The Agency is requesting approval to increase expenditure funding for the remainder for IHSS Public Authority (PA) services by $82,635.00, and to amend the Sourcewise agreement from $1,055,472.00 to $1,138,107 for the remainder of FY 2014. Based on current legislation, the Agency will receive $82,635,00 in federal and state revenue, with no increased cost to the County General Fund.
The ongoing annualized funding increase requested for the Sourcewise agreement is $252,348.00, and the agreement would be amended to reflect the ongoing change from the current amount of $1,055,472.00 to $1,307,820.00 beginning in FY 2015. Based on current legislation, the Agency will receive $252,363.00 in federal and state revenue, with no increased cost to the County General Fund.
Currently, any PA cost increases above the MOE base would be covered by state and federal funds. However, the state is considering clarification for PA cost increases which exceed the current base MOE amount. If the state changes the current interpretation for Public Authority (PA) cost increases, the Recommended Action would be result in a 50/50 county and federal cost participation. Under this scenario, the FY 2014 net increased cost to the County General Fund would be $41,318.00 and the ongoing net increased cost would be $126,174.00.
In 1992, California enacted legislation to define the role of Public Authorities established by County Boards of Supervisors to provide the delivery of IHSS. In December 1996, the Santa Clara Board of Supervisors adopted an ordinance creating the IHSS Public Authority to act as the employer of record of IHSS providers for purposes of collective bargaining. In addition to being the employer of record, Public Authorities are required to establish and operate a provider registry of available and qualified independent providers for referral, to investigate the qualifications and background of potential providers, and to provide access to training for providers and recipients.
Sourcewise provides IHSS public authority services including, but are not limited to maintaining a registry and conducting benefits administration and training for IHSS providers. Sourcewise is a sole source contractor due to their long standing presence in the community, experience working with the target population, and understanding IHSS recipients and providers needs relating to the administration of the program. Sourcewise has developed administrative efficiencies including creating and maintaining a registry software and other software tools to successfully meet the mandates of the Public Authority. Sourcewise has a proven track record of having the capacity to assume greater responsibility over administrative and direct service activities as the scope and responsibilities of the Public Authority have increased.
The funding increase will enable Sourcewise to add four positions to support IHSS Registry services to provide greater support to IHSS consumers and homecare workers in a timely manner. Currently, the funding provides three positions for Registry Services, prior to funding reductions in 2010 the Registry had eight positions. The additional staff requested is necessary to:
· implement new Fair Labor Standards Act (FLSA) requirements related to overtime regulations
· support additional workload to recruit, screen and train an additional 1,000 homecare workers that will be necessary to meet the increased demand from IHSS consumers to alleviate overtime issues (effective January 1, 2015)
· revise list of workers registry hours to correct availability
· follow up with consumers after hiring worker from Registry List to improve longevity of consumer/worker match
· improve Registry response time
· reduce number of calls going to voicemail
· ensure call back within five business days
· provide support to investigate, follow up, and attempt to resolve complaints made by consumers or workers within 24 to 48 hours after being received (currently can take up to a month to resolve issues)
IHSS Postage and Printing
The funding increase will provide the additional postage and printing in order to produce the Consumer Newsletter for IHSS consumers in the fourth quarter of the current fiscal year. Prior to 2010 funding reductions, a quarterly Consumer Newsletter was issued for consumers as a tool for providing educational topics such as: How to be a Good Employer, Communicating With Your Provider, IHSS and Fraud, Prevent the Spread of Infections, and other relevant topics. The Consumer Newsletters were an effective tool in regularly communicating with IHSS consumers, their family and workers. The absence of regular communication tool has resulted in consumer complaints about lack of communication. Also, the Consumer Newsletter provides required information to consumers and family regarding critical issues such as hour reductions, payroll processing issues/tips, pending legislation, and how to protect themselves from severe weather, flu and other topics.
IHSS Equipment, Supplies and Indirect Cost
The funding increase will cover the cost associated with the equipment required for the additional Registry positions. Additionally, the funding increase will cover cost associated with supplies and other indirect costs.
Employee Services Agency supports the recommended action.
The recommended action will have no/neutral impact on children.
The recommended action will have a positive impact on the seniors served through the In-Home Supportive Services.
The recommended action will have no/neutral sustainability implications.
IHSS is a program designed to prevent institutionalization of elderly, blind or disabled people when they are no longer able to fully care for themselves or handle routine household tasks. The purpose of the program is to allow these individuals to live safely at home rather than in costly and less desirable out of home institutional placement.
Multi-lingual social workers and staff perform assessments, determine eligibility and calculate the number of authorized monthly service hours of approximately 18,000 clients. Tasks covered are categorized into four groups: domestic or household services; personal care services; services directed or provided by a licensed health care professional; and other miscellaneous services.
CONSEQUENCES OF NEGATIVE ACTION
The Agency would not be able to augment staffing services necessary to provide direct client services, perform state and federal mandated accounting and financial management and expense reimbursement, manage legislative analysis, oversee technology automation and systems support, and perform Public Authority registry, benefits administration and provider training activities.
STEPS FOLLOWING APPROVAL
The Clerk of the Board’s Office is requested to send MinuteTraq notification of completed processing to Daniel Crick, Financial Management Services, Social Services Agency.