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Health and Human Services Agency, Social Services Division, recommending the Board approve and authorize the Chair to sign a letter to the State opposing the discontinuation of the In-Home Supportive Services (IHSS) Coordinated Care Initiative, which dismantles the IHSS Maintenance of Effort cost sharing arrangement.
FUNDING: 1991 Realignment.
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DEPARTMENT RECOMMENDATION:
Health and Human Services Agency (HHSA) recommending the Board of Supervisors approve and authorize the Chair to sign a letter to the State which opposes the discontinuation of the In-Home Supportive Services (IHSS) Coordinated Care Initiative (CCI) effective January 1, 2018. The impact of discontinuing the CCI will result in the existing Maintenance of Effort (MOE) cost sharing arrangement between the County and State ending June 30, 2017, and an increase in Net County cost.
DISCUSSION / BACKGROUND:
The County is mandated to provide IHSS services to Medi-Cal beneficiaries who meet eligibility criteria. These mandated services provide assistance to the most vulnerable populations - helping to sustain the health, safety, and well-being of aged and disabled adults, disabled children, and families. The intent is to help these clients achieve the highest level of independence possible while living in their own home, thereby avoiding costly institutionalization. Each individual receiving IHSS services is managed by an IHSS worker and IHSS caseloads in El Dorado County continue to increase: FY 2013-14 IHSS managed 788 cases; FY 2014-15 IHSS managed 905 cases; FY 2015-16 IHSS managed 1033 cases; and in January 2017 IHSS managed 1228 cases.
Enacted in 2005, the Managed Care Organization (MCO) tax allowed the State to increase their participation in IHSS costs by creating a County Maintenance of Effort (MOE) that capped the County financial responsibility. Then, in fiscal year (FY) 2013-14, the Coordinated Care Initiative (CCI) was implemented statewide, which provided coordinated...
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