COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

November 22, 2002

BOARD MEETING DATE:

December 17, 2002

TO:

Honorable Board of Supervisors

FROM:

Margaret Taylor, Director of Health Services

Charlene A. Silva, Director of Aging and Adult Services

SUBJECT:

Appropriation Transfer Request for In-Home Supportive Services Public Authority

Recommendation

Approve an Appropriation Transfer Request (ATR) adding $594,000 in revenue and appropriation to the In-Home Supportive Services Public Authority budget and $594,000 in appropriation to the IHSS General Fund unit.

Background

In September 1993, your Board approved an ordinance establishing a separate Public Authority to administer the provider components of the In-Home Supportive Services Program (IHSS) and designating the San Mateo County Board of Supervisors as the governing Board of the Public Authority.

The goal of IHSS is to assist eligible aged, blind, and disabled individuals to remain in their own homes and avoid institutionalization. Using independent providers, IHSS provides participants with a wide variety of basic services such as meal preparation, feeding and bathing, protective supervision, laundry and shopping, transportation, house cleaning, and certain paramedical services authorized by a physician.

A worker registry and referral system to assist clients in securing qualified workers (independent providers) has been an integral part of the Public Authority's model from the start. The Public Authority recruits, screens, and matches independent providers with clients. Recruitment, training, and retention of service providers have been key to effective service delivery. Furthermore, the creation of the Authority as the "employer of record" has allowed the independent provider workforce to engage in collective bargaining. The independent providers are represented by Service Employees International Union (SEIU), and the Public Authority negotiates with the union.

Discussion

Your Board, acting as the IHSS Public Authority concluded negotiations with SEIU for IHSS independent provider services on September 25, 2002. As a part of the negotiations it was agreed that salaries for the independent providers would be increased $1.00 per hour from $8.50 per hour to $9.50 per hour effective October 1, 2002. On September 27, 2002, your Board approved a resolution to that effect.

The IHSS Public Authority budget includes only the county share of the cost of independent provider wages (including taxes and worker's compensation). This is because the payments are made directly by the state to the providers and the state in turn invoices the Public Authority for only the county's share of the cost. As a result neither the state nor federal shares of the cost of wages nor the associated state and federal revenues for independent provider wages are included in the county's budget. The General Fund pays a portion of the total county share for IHSS services. The balance is paid largely with Realignment revenues. Because the General Fund contribution is included in the Health Services budget for transfer to the Public Authority, this ATR, which provides the revenue and appropriation to pay the county share of the wage increase, adds revenue and appropriation to the IHSS Public Authority budget and adds appropriation to the Health Services Public Authority budget unit.

Vision Alignment

Independent provider services keep the commitment of ensuring basic health and safety for all and goal number 8: People- Help vulnerable people-the aged, disabled, mentally ill, at-risk youth and others-achieve a better quality of life. Funds for these services will contribute to this commitment and goal by helping clients to remain safely in their own homes.

Fiscal Impact

The increase of $1.00 per hour plus approximately $ .10 per hour in payroll taxes for nine months (October 2002 through June 2003) will cost an estimated $2,517,000. The county share of this cost is estimated to be $594,000 based on projected state and federal reimbursement of 76.4% of this cost. The estimated county share is approximately 23.6% of the total cost. This ATR adds $594,000 in appropriation to the IHSS Public Authority - General Fund unit within Health Services. It also adds $594,000 in Interfund Revenues to the IHSS Public Authority and the same amount to appropriation for independent provider pay. The Net County Cost of this action is $594,000. The 2002-03 Approved Budget for General Fund contribution to IHSS is $4,010,077. The total revised General Fund contribution to IHSS is $4,604,077.