HomeMy WebLinkAboutMINUTES - 12221992 - 2.1 TO: BOARD OF SUPERVISORS ......
FROM: Supervisor Tom Torlakson f —�`,,,. Contra
Supervisor Tom Powers =
Finance Committee COSta
County
DATE: December 22, 1992 0•.• - ��
STA_If OUK
SUBJECT: Social Service Department Budget Reduction Plan - Phase 3
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
RECOMMENDATION(S):
1. ACCEPT the Finance Committee report on the Social Service Budget Reduction Plan-Phase 3.
2. DIRECT the Social Service Department to work with the Foster Parent Association to explore
areas where they might help the Department meet the needs of dependent children, taking into
account the need to maintain professional oversight, meet legal responsibilities and avoid
financial liability.
3. ACKNOWLEDGE the efforts of the Social Service Department to streamline the Child Welfare
Services (CWS) process through adoption of a uniform checklist on difficulty of care
assessments; reducing the number of difficulty-of-care assessments by workers from twice per
year to once per year; application for a waiver from the State to similarly relax the six month
reinvestigation requirement in foster care to once per year; and DIRECT the Social Service
Department to continue to take actions to simplify and streamline its operations, including waivers
on forms mandated by the State and accelerated adoption of the computerized CWS case
management system.
4. REQUEST that the Presiding Juvenile Court Judge meet with representatives of the County
Administrator's Office, County Counsel, Public Defender's Office and Social Service Department
to explore ways to reduce paper work and court continuances on child welfare cases, at the
same time protecting the welfare of the dependent child.
5. DIRECT the County Administrator and Social Service Director to work with the State to ensure
that the Title XIX Personal Care Option funding does not increase the County required match in
the program, improves client services and, consistent with these guidelines, is put into place as
expeditiously as possible.
6. ADOPT the recommendations of the County Administrator and Social Service Director in the
December 15, 1992 report to the Board on the Social Service Budget Reduction Plan-Phase I.
CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR_RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
i
SIGNATURE(S):
Tom Torlakson Tom Powers
n �
ACTION OF BOARD ONl9APPROVED AS RECOMMENDED_OTHER
The Board APPROVED the above recommendations, and in additon those added
orally by the Committee members. See Addendum to Item 2.1 attached.
VOTE OF SUPERVISORS
I HEREBY CERTIFY THAT THIS IS A
UNANIMOUS(ABSENT , TRUE AND CORRECT COPY OF AND
AYES: NOES: ACTION TAKEN AND ENTERED
ABSENT: ABSTAIN: ON MINUTES OF THE BOARD OF
SUPERVISORS ON THE DATE SHOWN.
Contact: Perfecto Villarreal,313-1579
ATTESTED
PHIL BATCHELOR,CLERK OF
THE BOARD OF SUPERVISORS
AND COUNTY ADMINISTRATOR
cc:CAO /'�
BY C. ,DEPUTY
ADDENDUM TO FINANCE COMMITTEE REPORT
ITEM 2 .1 ON THE DECEMBER 22, 1992 AGENDA
The Finance Committee members reviewed their recommendations and
commented on the discussion at the Committee meeting earlier this day,
and made additional recommendations to be added to the committee
report.
The Board APPROVED the recommendations included in the written
report as well as the following items added by the Committee at this
time:
7 . DIRECT staff to develop a team of County employees, lobbyists,
board members and representatives from employee organizations
to work with our legislative delegation to draft and introduce
legislation to relieve the state-mandated workload in the CWS
program, to modify the CWS allocation formula and to ensure
that the State Department of Social Services allocates the
current Child Welfare Services Reserve funds of $4 million to
counties which received CWS allocation reductions .
8 . DIRECT the Social Service Department to report to the Finance
Committee on January 11, and the Board of Supervisors on
January 12, on the progress made by the Department 's work
group in addressing the structure and prioritization of worker
and supervisor assignments in Children's Protective Services
and any further information or developments in the Title 19
Personal Care Option funding.
9 . DIRECT that these program reductions be considered as part of
the Budget Task Force deliberations in terms of any new
revenue raising mechanisms, such as a 1/4 cent or 1/2 cent
sales tax.
10 . DIRECT that the IHSS positions abolished today would be
restored if additional revenue from Title 19 is realized, and
that the employees affected by the lay-off be placed in the
appropriate County pools for call-back or temporary work.
,
BACKGROUND/REASON(S) FOR RECOMMENDATIONS:
At its December 15, 1992 meeting, the Board of Supervisors referred the Social Service Department Budget
Reduction Plan to the Finance Committee for review and report back to the Board on December 22, 1992. The
Board requested that the Finance Committee look at specific issues regarding staffing levels,workload reductions
and cost savings/new revenue.
Staffing Levels
The Board requested information on the individual positions that are being considered for reduction, the rationale
for their selection and information on the ratio of administrative to line workers.
The Department is recommending that the staffing in CWS be set at the State authorized levels: 123 Line
Worker FTEs and 19 Line Supervisor FTEs. The State set the Line Worker FTE allocation based on their
projections of the number of cases within the four CWS subprograms, using State adopted workload factors.
These are:
Subprogram Workload Factor
Emergency Response 15.8 dispositions/month
Family Reunification 27 cases/month
Family Maintenance 35 cases/month
Permanent Placement 54 cases/month.
The number of Line Supervisors was determined by the State established Line Supervisor/Line Worker ratio of
7 to 1.
The Social Service Department believes, and most counties concur, that CWS is not adequately funded by the
State. Furthermore, the State has a practice of not funding COLAs (and acting on these disallowances one to
two years in arrears). The timing of the allocations is also a grave difficulty for the counties. Contra Costa
County received its formal notification of the allocation on December 8, 1992 (informal notification in November).
The allocation applies retroactively to July 1, 1992.
The proposed staffing level of 142 FTE in the CWS program is the State authorized level, but does not address
the deficit caused by "overstaffing" from July 1, 1992 to the present. The Social Service Phase One Budget
Reduction Plan addresses $1.9 million of the $3.17 million shortfall in the department.
The proposed In Home Supportive Services (IHSS) staffing reductions are also the result of•lower funding
allocations, $200,000, received from the State in November.These allocations are similarly based on the State's
assessment of our caseload.
Proposed changes in staffing are summarized below:
CURRENT AND PROPOSED STAFFING LEVELS
Adult Services Current FTEs Proposed FTEs
Management (Division Manager) .5 . 5
Administrative (Prog. Anal., Quality Control) 1 .5 1 . 5
Line Supervisors 4 . 0 3 . 0
Line Workers 18 . 3* 14 . 3*
Children's Services
Management (Division Managers) 3 .5 3 .5
Administrative (Program Analysts) 3 .0 3 . 0
Line Supervisors 21 . 0** 18. 0**
Line Workers 145 . 0* 125 . 0*
Even with the proposed staffing reductions, the number of social caseworkers is still significantly
higher than 1986-87 staffing levels, an increase from 100.2 FTEs to 130.95 FTEs (an increase of
30.7%). At the same time, social workers have been reduced only marginally, from 70.3 FTEs to
68.3 FTEs (minus 2.8%). During these same time periods, management has been reduced by
45.9% and administrative positions by 37.2%.
* Excludes clerical support staff (funded through administrative support allocation for all service
programs).
** Includes Licensing and Adoption staff.
2
1.
STAFFING COMPARISON 1986-87 TO 1993
(Filled, Full-Time Equivalents)
Actual Proposed Percent Change
1986-87 Current 1/15/93' from 86-87
Management2 37.00 21.00 20.00 -45.95%
Administrative 63.70 40.00 40.00 -37.21%
Line Supervisors4 90.00 96.00 91.00 +1.11%
Line Workers 693.90 805.00 786.10 +13.28%
TOTAL 884.60 962.00 1937.10 +5.93%
The previously adopted management position decreases now mean that Managers are 2.1% of the
total proposed workforce, versus 4.2% of the total workforce in 1986-87. Administrators (16 of 40
positions are unrepresented line administrators) are responsible for the administrative support
(fiscal, budgetary, personnel, computer systems, regulatory interpretation and program
administration) and organization of the line functions. Under the Budget Reduction Plan, line
administrators will comprise only 4.2% of the workforce, versus 7.67% in 1986-87, despite
significant increases in the number of Line Workers whom they support.
As of January, 1993, the Department will have nine offices staffed by line workers in the three
regions of the County; 8 of the 9 offices provide direct services to clients, and the other is a storage
of case material accessed by workers. In order to provide the management for each of those
buildings, it is necessary to physically locate Division Managers on-site. The Department is
organized by programmatic area into Bureaus, which is a concept that line staff have supported
because it gives them more direct support and access to the chain of command in their given
program area. To reduce Divisions Managers further would result in an inability to continue the
geographic and bureau coverage, and a serious lack of organizational support for line staff and
supervisors. The September, 1992 reductions, for example, resulted in one Division Manager being
given responsibility for policy and development in Child Welfare Services and Adult programs as well
as supervision of Adult Services Operations in four geographical locations throughout the county.
This Division Manager directly supervises 8.5 FTEs in 7 program areas: East County IHSS (1.0
FTE Social Work Supervisor I; i.e., SWSI); Central County IHSS (1.0 FTE SWSI); Adult Protective
Services (1.0 FTE SWSI); IHSS Payroll (.5 FTE Clerical Sup.); CWS Policy Development (3.0 FTE
Program Analysts); Adult Services Policy Development (1.0 FTE Program Analyst); and Quality
Control (1.0 FTE SW).
In the Child Welfare Bureau, staff are located in three areas: Antioch, Martinez and Richmond. The
nature of the work in the protection of children includes legal mandates for sign off and review by
supervisors and/or managers within specific immediate time frames. Supervisors frequently review
and consult with Division Managers particularly on casework decisions which have broad policy
ramifications to insure consistency throughout the Department. For that reason alone, it is important
to have managers on-site in each of the three Child Welfare offices. Additionally, those managers
each have numerous special project and community liaison assignments particular to their
geographic region of responsibility. The ability of the Division Manager to physically carry out those
assignments would be seriously affected if staff reductions forced centralization of CWS.
'Includes reductions effective 12/31/92 previously ordered by Board and the 10 requested new
Eligibility Workers.
2Includes Director, Assistant Directors, Division Managers, Personnel Officer, Systems
Officer, Office Managers, Executive Assistants, EW Sup II, AAA Director, Welfare Fraud
Manager.
3Includes AAA Staff Assistants, Administrative Analyst series, Personnel Analysts, Dept.
PC Coordinator, Program Specialists and Program Analysts, Systems Analysts, Appeals
Officers, Secretaries, Data Operations Specialist, Pre-Hearing Review Specialist.
4Includes Clerical, Eligibility, Welfare Fraud, Social Work, Vocational Supervisors,
Volunteer Program Coordinators.
3
The East County CWS Division Manager directly supervises 12.0 FTEs, with staff in two locations.
The manager supervises the following 9 programs: Emergency Response (2.0 FTE SWSII); Family
Maintenance (1.0 FTE SWSII); Family Reunification (1.0 FTE SWSII); Permanent Placement (2.0
FTE SWSII); Court Representative (1.0 FTE SWSII); Children's Residential Placement (1.0 FTE
SWSII); Specialized Placement (1.0 FTE SWSII); Clerical Supervisor (1.0 Clerical Sup.);
Independent Living Skills Program (2.0 FTE Contractors). In addition, the Division Manager is
responsible for liaison with Families First, liaison with Bay Area Regional Shelter Providers,
represents the County on the County Welfare Director's Regional Committee, acts as the Building
Manager and approves all placement of children in for—profit facilities.
The Central County CWS Division Manager directly supervises 10.0 FTEs in 9 program areas:
Emergency Response (2.0 FTE SWSII); Family Maintenance (1.0 FTE SWSII); Family Reunification
(1.0 FTE SWSII); Permanent Placement (1.0 FTE SWSII); Countywide Licensing (1.0 FTE SWSII);
Countywide Adoption (1.0 FTE SWSII); Countywide Emergency Response Screening/Family Pres.
(1.0 FTE SWSII); After—Hours ERP/CWS Clerical Specialists (1.0 FTE SWSII); Clerical Supervisor
(1.0 Clerical Sup). In addition, the Division Manager acts as Building Manager for the Muir Road
facility.
The West County CWS Division Manager directly supervises 9.5 FTEs in 8 program areas:
Emergency Response (3.0 FTE SWSII); Family Maintenance (1.0 FTE SWSII); Family Reunification
(3.0 FTE SWSII); Building Manager (.5 FTE Clerical Sup); Living Free Program (1.0 FTE
Contractor); Heritage Project (1.0 FTE Contractor). In addition, the Division Manager acts as
Building Manager and is responsible for liaison with the Juvenile Court.
The funding allocation shortfalls in Child Welfare Services and IHSS are restricted funds that may
be used only for line staff, supervisors and direct costs in those programs. It is therefore not
possible to avert line reductions in those programmatic areas by reducing management/
administration further, without the commitment of County General Fund revenues .
State and federal funding allocations to the Social Service Department for these programs can
basically be divided into three categories:
1. Dedicated funding for line workers and immediate supervisors who have direct client
supervision.
2. Overhead administrative costs allocated to the specific program.
3. Overhead administrative costs funded by all service programs (approximately 30
throughout the department).
The Social Service Department is currently within its administrative allocation. Revenues received
for administrative overhead cannot be shifted to direct provision of services. Consequently,
reduction of administrative staff would only reduce the support to the line workers, not increase the
ability of the department to provide direct client services.
Workload Reductions/Organizational Streamlining
The Board of Supervisors also asked the Finance Committee to look into issues that could reduce
the workload of the line workers and/or streamline operations, including :
• limiting the number of hours the department is open to the public to 9:00 a.m. to 4:00 p.m.
only.
• utilizing the foster parents in Child Welfare Services to relieve professional staff.
• simplifying the paper work process associated with the court system.
• other organizational efficiencies.
4
Limited Hours
The Social Service Department met with representatives of the employee organizations regarding
limiting the hours the department is open to the public. Concern was expressed regarding the effect
of limited hours on Eligibility Workers (in the income maintenance programs), Social Workers and
Social Casework Specialists (CWS and Adult Services). These workers felt that they needed as
much time as possible to meet with their clients. The Department concurs that limiting hours is not
advisable at this time.
Foster Parents' Association
During the December 15, 1992 hearing before the Board of Supervisors, the president of the Foster
Parents' Association suggested that they may be able to work with the Department to ameliorate the
funding allocation reductions. Over the past few years, the Department has been meeting with
officers of the Foster Parents' Association on a quarterly basis. Foster parents have participated on
task forces and provided input in the area of policy development. The Department would like to
continue with these efforts including identification of ways that they might assist the Department in
providing for the needs of dependent children. However, volunteers are never a replacement for
professional staff. The County has legal responsibilities for the assessment and monitoring of these
children. In addition, we must be very careful not to take any actions which would expose us to
financial liability.
Court Procedures
With regard to the court process for CWS, the Department has a number of concerns. .The
Department must respond to court mandates; however, a considerable amount of time is lost when
staff is forced to wade through a system which can no longer accommodate what it could in the
past. Any modification would need concurrence from the presiding Juvenile Court Judge in
consultation with the Public Defender's Office, County Counsel and Social Service Department. The
Department recommends that the Board request that the presiding Juvenile Court Judge work with
the Department in addressing the need for simplification and streamlining to better meet the needs
of our young clients.
Workload Reductions
The Department has taken many steps to reduce the workloads of the line workers to the extent
permitted under state or federal regulation. For example, the change in difficulty-of-care (DOC)
rates in the foster care program resulted in an increase of forms. This action ensured more
standardization in the application and use of the DOC policy. The Department established a
uniform checklist for workers to complete regarding the child's physical and emotional problems. In
addition, a separate form lists what foster parents agree to do to help the children. Based on a
uniform "point system," the difficulty-of-care rate is calculated and reviewed in the district office and
then sent directly to the Eligibility Worker to either start or change the payment.
In areas where the County has control, the Department has taken action. For example, workers now
will do a yearly assessment of the difficulty-of-care foster care rates instead of an assessment
every six months. The Department is also being very supportive in the development of the statewide
computerized CWS case management system.
In other areas, the Department has requested waivers from the State. For example, the Department
has requested a waiver to change the six month requirement for reinvestigation in foster care to a
one year requirement.
5
c i
Organizational Efficiencies
Part of the Budget Reduction Plan proposal includes a reorganization of the Child Welfare Services
function. The Department's highest priority is to preserve those positions which have direct client
contact. Over the years, the Department developed a series of specialized units. These functions
will now go back to the individual caseworker so one caseworker will handle every aspect of the
case. These actions will entail:
1) Distribute Emergency Response Screening Function to District Offices:
The Emergency Screening Function now operates as a centralized function. This unit takes
all emergency calls and determines whether emergency, immediate response is necessary or
if the normal response time is adequate. Referrals are then sent to the District Offices for
action. Under the reorganization, the District Offices will perform their own screening.
2) Combining the Placement Units under a Single Supervisor:
This reorganization retains the current specialized assignments for the Children's Residential
Placement Unit and Specialized Placement Unit, but combines them under the supervision of
one Social Work Supervisor. Retaining Children's Residential Placement Unit will maintain
controls for cost purposes and for coordinating services to children in placement facilities.
Case workers are assigned to specific facilities located throughout the State thereby reducing
duplication of staff time and cost expenditures. The Specialized Placement Unit handles very
disturbed children who are placed in specialized foster homes. The Unit helps avoid
placement in more expensive residential facilities by providing a high level of support to foster
parents. Additionally, it maximizes the opportunities for reunification.
3) Distribute the Court Unit into the District Offices:
Our current court unit system disadvantages the department in its fiscal claiming by delaying
the count received for a disposition. The distributionof the court units into the District Offices
will help the Department maximize its receipt of federal and state funds by reducing the
number of times a case is transferred between case workers in specialized programs. The
integration of the court activities into designated programs will also provide more continuity of
services and reduce duplication of efforts.
4) Elimination of the Parent Search Clerks:
This will return responsibilities to the case worker. Since the Parent Search Clerks are
counted in the allocation as caseworkers, but can perform fewer functions, this action
preserves the greatest number of workers with the broadest range of skills to work with
clients.
5) Elimination of Parent Aides:
Elimination of the staff in this class will also return the responsibilities to the case worker.
The same issues of efficiency and cost relate here with the Parent Search Clerks. As the
primary duties of the class are transportation of children and parents to required
appointments and supervision of visitation, the demands on the worker are such that this is a
lower priority than emergencies and court work
Restructuring of CWS Work Duties
The Department has discussed with representatives of the 535 Line Workers and Line Supervisors
the formation of a group to address the structure and prioritization of worker and supervisory
assignments in Children's Protective Services. It is anticipated that those discussions would begin
no later than the week of January 4, 1993, subject to action taken by the Board. As a result of such
a working group, there may be some internal modifications of the specific programmatic and
organizational impact outlined in the materials submitted to the Board.
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Cost Savings/New Revenue
The Board also asked the Finance Committee to explore areas of cost savings and new revenue
including voluntary and mandatory furlough, the effectiveness and need for the After-Hours
Emergency Response Program, General Assistance Centralization and the Title XIX Personal Care
Option Funding.
Furlough
The Department instituted a voluntary furlough program in July, 1992. Since then, 80 requests have
been received. The disposition of each is noted below:
VOLUNTARY FURLOUGH/LEAVES OF ABSENCE
Number Percentage
Approved 48 60%
Reconsider after GA 13 16%
Centralization
Re-submit w/Unit 5 6%
Vacation Coverage Plan
Withdrew Request 1 1%
Denied - workload related 13 16%
80 99%
Mandatory furlough is a meet-and-confer issue. Consequently, any decisions on mandatory
furlough would need to be taken following consultation with the employee organizations. In addition,
there would need to be an assessment of the mandatory and 24 hour functions within the
Department, reductions in the savings estimate applied to those functions. After considering the
effect on federal and State revenue, it is currently estimated that the Department would have to
close for 2 months in order to completely eliminate the $3.17 million projected shortfall.
After-Hours Emergency Response
The Board of Supervisors received a petition from numerous employees on dismantling the After-
Hours Emergency Response function. (See Attachment 1) The Department had not recommended
this option since it is a meet-and-confer issue and there had been a high level of staff support for it
in the past. The petition alters this situation.
Currently, the program is staffed with three Social Work Casework Specialists and .5 FTE
Supervisors (the State requires supervisorial sign-off on many actions in these cases). These
workers receive both a differential for the night time duty and overtime. Overtime runs $80,000/year
($47,000/year net County costs).
The law requires that the Social Service Department maintain a response system which provides 24
hours a day, seven day a week response to reports of abuse, neglect or exploitation. The degree of
service to maintain the system varies among counties. The Department would like to look at other
alternatives to current staffing arrangements; such as rotating caseworkers, lowering coverage
levels and utilizing the resources of law enforcement agencies. Since this issue would require both
reorganization and discussion with the employee organizations, the Social Service Department would
like to report back on this issue during the Phase 4 Budget Reduction hearings.
7
General Assistance Centralization
Centralization of General Assistance (GA) will save the County in excess of $1 million over a five
year period. (See Attachment 2) The Department has met extensively with the community to
resolve concerns regarding transportation. Renovation of the Muir Road facility is now complete
and the Department is scheduled to complete its move the first week of January. GA centralization
will not only save funds, it will enhance our service delivery system for both the GA client and the
workers:
• Improved working environment for workers including expanded space, superior facilities and
improved security system.
• Larger classrooms, a larger reception area, increased numbers of interview booths and
increased telephone accessibility for clients.
• More efficient use of GA eligibility and services staff.
• Higher levels of consistency in program and policy application.
• Better service delivery to clients through the ability to monitor application flow and in-take
procedures (See attached for details of the savings and efficiencies of GA Centralization).
Title XIX Personal Care Option Funds
Title XIX is the federal funding for administration of the In-Home Supportive Services (IHSS)
program. Under the Personal Care Option (PCO) of Title XIX, certain services provided by IHSS to
eligible recipients may qualify for additional federal funding. The State Department of Social
Services (SDSS) received approval of the Title XIX State Plan Amendment from the Health Care
Financing Administration (HCFA) in November and has proposed an ambitious schedule for
implementation of the PCO program statewide by April 1, 1993. However, SDSS staff stresses that
many specifics of PCO implementation still need to be negotiated with HCFA.
Many actions must take place and many questions must be answered prior to implementation.
(See Attachment 3) The Personal Care Option is not simply a way to claim more federal funds for
the existing IHSS program, but is a new program which will supplant a portion of the IHSS program.
The cases targeted by PCO are those cases which require personal or medical care due to a
medical or psychological disability, rather than those cases which need only domestic services to
avoid institutionalization. It is unknown what portion of the current 4,142 Contra Costa.IHSS cases
will be eligible for the additional federal financial participation. However, SDSS estimates that 70%
of the statewide caseload may be eligible, while other counties have assumed 50%. Therefore, our
fiscal impact analysis (see below) assumes a range of 50% to 70% for Contra Costa County's
caseload. It is also unknown whether or not the PCO funding will replace the current Title XIX
funding for IHSS, however, since its purpose is the same as the current Title XIX program, it is
likely. Also, the State has announced that, after implementation of PCO, it will restore the 12%
reduction in IHSS services which was made as part of the fiscal year 1992-93 budget reduction.
This will result in an increase in the services the County is required to provide, with a consequent
increase in our funding share.
The PCO program will be quite different from the IHSS program, as noted below:
IHSS PCO
No nurse involvement Registered Nurse supervision of cases
Cap on hours/month Cap of 283 hours/month for all cases
of either 195 or 283
Medical report optional Annual physician certification req'd
8
The funding ratios for the programs will also differ. Currently, funding for the IHSS program is as
follows:
Services: 65% State; 35% County
Administration:
Federally eligible cases: 50% Federal ; 32.5% State ; 17.5% County
Non—federal cases: approx. 70% State; 30% County
However, because the State puts a limit on the expenditure level in which it will participate, our
county incurs expenses above our base allocation from the state for which we can only claim the
50% federal share.
Under the PCO program, services will also be eligible for 50% federal participation. The ratios will
therefore be 50% Federal; 32.5% State; 17.5% County. SDSS has informally told us that the new
administration ratios will be 50% Federal; 35% State; 15% County. They did not specify whether or
not there will be a cap on the State's participation. However, it is extremely unlikely that the State
will take any action to increase its costs and will more likely seek to reduce its participation.
Using information currently available, staff has prepared a fiscal impact analysis of implementation
of the PCO program in Contra Costa County. The results of the analysis show that the fiscal
impact could range from a loss of $914,000 to a gain of $639,000, on an annualized basis.
Please note that the accuracy of this analysis is constrained by the high number of assumptions
which were required due to the lack of definite information. Listed below are the assumptions
incorporated into the fiscal analysis:
1. Caseload eligible for PCO will range from 50% to 70%.
2. The current Federal funding for IHSS will be replaced by PCO.
3. The State will cap their administrative expenditures for both programs at the current
expenditure level for IHSS.
4. A new workload factor of 127 per social worker will be applied to both the new PCO program
and the residual IHSS program.
5. A supervisory ratio of 1 :7.
6. The RNs providing oversight to the PCO program will have caseloads of 140 (110% of the
Social Worker caseload).
7. RN salaries will be $4,200 per month, with 31% benefits, and the same overhead costs as
the current IHSS social workers.
8. An estimate of current IHSS expenditures for comparison.
SDSS received notification in November of approval of the Title XIX State Plan Amendment for the
Personal Care Option by the federal Health Care Financing Administration. The County Welfare
Directors Association (CWDA) has established a task force which is working closely with SDSS on
PCO implementation. This task force met for the first time on December 11, will meet again on
December 22, and will meet weekly beginning the second week of January. Listed below are some
of the remaining actions which must be completed in order for this program to be implemented.
9
Proposed
State Actions Required to Implement PCO Completion Date
Department of Finance approval of State Plan Unknown
Develop administrative allocation December
(no draft as of 12/16/92)
Obtain CWDA approval of allocation December
(Joint Committee met 12/11, & will again 12/22)
Develop & distribute fiscal instructions 1/15/93
to counties
Provide training to 58 counties 1/30/93
Draft & file emergency State Department of Health 2/1/93
and Department of Social Services regulations
Design, test & implement new programming 4/1/93
for State automated system (CMIPS)
County Actions Required to Implement PCO: Completion Date
• Review cases and identify PCO eligible clients unknown
Make arrangements for RN supervision of unknown
PCO cases
Implement new fiscal claiming process unknown
Representations were made at the December 15, 1992 Board meeting that other counties were
already taking action to expand their IHSS programs based on potential PCO funding. Sonoma
County and San Mateo County were specifically mentioned. Staff has contacted those counties for
a status report on their activities. Neither will be acting prior to the State's determination of
allocation and assessment of the funding impact on net county costs, which will occur mid-January
1993 at the earliest. However, this would require action by the Department of Finance which is
currently reviewing the PCO proposal.
Sonoma County submitted a pilot application to the State in July to reorganize their IHSS program
under the PCO concept. That pilot program assumed that Sonoma County would be able to
maintain its current IHSS caseloads (over 200 per worker). Sonoma County informs us that they are
currently re-evaluating the program and staffing requirements. Upon completion of the State
allocation plan, they will make appropriate recommendations to their Board of Supervisors.
San Mateo County's IHSS program is organized very differently than most counties. San Mateo
combines its Social Services IHSS program with its AID Case Management program, Multi-Purpose
Senior Services program and Linked Case Management program. Consequently, it is funded from a
variety of sources. San Mateo County is considering a "public authority model" authorized in 1992
by SB 485. This will allow San Mateo County to establish a public authority to negotiate wages and
benefits for IHSS providers, but allow the client the right to hire and fire the service provider
themselves. The San Mateo Board of Supervisors is scheduled to hold a hearing on this concept on
January 15, 1993. San Mateo staff has informed us that the plan is contingent upon continued
allocation of State general fund monies for the IHSS program.
The Social Service Director attended a meeting of the County Welfare Directors on Thursday,
December 17, 1992 to discuss the PCO program (program update attached). Many of the County
Welfare Directors expressed concern over the uncertainties in the PCO program. None reported
that they would be moving ahead on any actions prior to definitive direction from the State on
program allocations and regulations.
10
ATTACHMENT 1
SOCIAL SERVICE DEPARTMENT Contra Costa County
TO: Perfecto Villarreal, DATE: December 11, 1992
Director
FROM: Children's Protective Services Staff
Antioch Social Services
SUBJ-. PROPOSED BUDGET CUTS
We, the undersigned, would like to propose that there are two programs within
Children's Services that could be elinunated, or revamped, in order to prevent the
elimination of line workers. These two programs are the Emergency Response After-
Hours Program, and the Centralized Screening Unit.
We feel strongly that given the current fiscal crisis, programs such as these, in which
the workers are not actually carrying cases, are "Luxury" programs this county can no
longer afford. It is common knowledge that the Emergency Response After-Hours
Program is very costly to the county. We, as workers in the .District, can attest that
the After Hours workers perform minimal functions, and the program., as it is now,
actually creates more work for staff in the district. The program should be redesigned
to be more cost effective. We realize these are very difficult times for all concerned,
but considering that the safety of the children in Contra Costa County could be
seriously jeopardized, we feel the first priority should be keeping line staff who
provide direct services to clients. There is no way that adequate services, or the
protection of children, can be insured with less staff. Therefore, we would like to
recommend that any program which employs Social Caseworkers who do not actually
carry cases be eliminated, or redesigned. There are matey staff members who have
ideas ;r suggestions on how the functions of these two programs can be redistributed
to the districts.
TIPnk you for y ur consideration towards this proposal.
14
/pai (A:BudgCt.m0111 #13-92)
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ATTACHMENT 2
ESTIMATED SAVINGS
GENERAL ASSISTANCE CENTRALIZATION
AVOIDED NEW
COSTS COSTS
ONGOING COSTS
Staff Reductions $468,836'
Transportation $250,000
Staff Increase (Clerical & PSOs) 84,5562
800 Telephone Number 4,5842
Courier Services 880
Building Lease 78,727
$547,563 $340,020
ONE TIME COSTS
Gates $ 2,292
PBX Cost 5,500
13th St/EI. Sob Reception Remodel 4.583
TOTAL $547,563 $366,144
FIVE YEAR SAVINGS $150113591
ONGOING YEARLY SAVINGS $2079543
FIRST YEAR SAVINGS $1815419
'includes benefit of shifting overhead costs to federal/state programs.
2Includes effect on net County cost for overhead.
I
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GA CENTRALIZATION OPERATIONAL BENEFITS
GA centralization will provide a significantly enhanced service delivery system. This, in turn, will
result in increased positive benefits to our GA clients. The highlights of this service delivery system
include:
■ Service to be provided In a building designed to meet the unique needs of the GA
program, clientele and workers
These building revisions were designed to accommodate the specific operational needs of the GA
program as well as to respond to staff concerns on floor plan layout as expressed at meetings with
SEIU Local 535. For example, they include the creation of three large classrooms for the many group
activities, a large waiting room area to handle the heaviest client volume, over 20 interview booths to
accommodate the many individual meetings workers have with their clients, a large reception window
area with seven reception stations (including low-height stations which are accessible to the special
needs of both handicapped clients and staff), an extensive security system which will have
strategically-placed video monitors and signal lights in each booth in addition to the standard panic
button, a toll-free 800 telephone number with multi-language automated attendant capabilities, and a
countywide local area network reception application system to enable GA applications taken in the
local district offices to be electronically transmitted to the GA centralized location without delay.
In comparison, with the exception of the Antioch office, the district offices which currently house GA
operations (particularly Weber) have inadequate group rooms and too few interview booths for GA
program operations.
■ An extensive security system has been installed for client and staff safety
In response to administrative and staff concerns about client and staff safety, the building will have
strategically-placed video monitors and signal lights in each booth in addition to the standard panic
button.
■ More efficient use of our GA eligibility and services staff.
By having all of our GA eligibility and Work Programs staff located at one large site, we will be able to
more quickly monitor and adjust our operations when needed. In terms of staff numbers, GA will be
administered by 73 line staff consisting of eight Eligibility units, one Work Programs Unit, and one
IGAR unit. These units are currently operating within portions of five district offices. Because they
are so spread out, an absence of one worker can significantly impact on that office's timely actions
and workload balance.
■ Higher level in consistency of program and policy application.
Staff at all organizational levels in GA will be co-located and operating as part of a closely knit team.
This working relationship will promote an increased level of accuracy in eligibility and grant
determinations as program problem areas will be more quickly identified during the day-to-day
discussions among the staff.
■ Better ability to monitor and, if needed, quickly adjust the application flow and intake
procedures
A better than timely processing of applications in accordance with established time frames will occur
as there will be consistency in application appointments and processing for clients countywide (rather
than being dependent on the intake processing circumstances of individual district offices).
�TTACITMENT 3
COUNTY WELFARE DIRECTORS
ASSOCIATION OF CALIFORNIA
December 14, 1992 17'It'?-.`t2
To: County Welfare Directors
From: Frank Mecca
Re: Implementation o Title XIX Personal Care Option -- Update #1
This is the first in a series of periodic updates intended to keep you apprised of, and seek
your input regarding implementation of the Title XIX Personal Care Option (PCO) for a
portion of the IHSS Program. At the November 1992 Board of Directors Meeting, the
Board assigned the preexisting Adult Services / Fiscal Committee to work with SDSS on
implementation of PCO (workgroup members are listed in Attachment 1). We had our
first meeting with SDSS on Friday, December 11.
Status of PCO / Key Dates
SDSS received verbal approval of its Title XIX plan amendment from HCFA in July
and written approval of the plan amendment in November. SDSS staff stressed
that the plan amendment submitted was quite general in nature, and many
specifics of PCO implementation still need to be negotiated with HCFA.
SDSS is shooting for an ambitious statewide implementation date of April 1, 1992.
They expect to have a regulation package promulgated in February. You will recall
that SB 485 (budget trailer bill) specified that PCO could be implemented only upon
certification by the State Department of Finance (DOF) that PCO will be fiscally
beneficial to both the state General Fund and to counties. Once this DOF
certification occurs and PCO is implemented, the 12 percent reduction in hours will
be restored.
Attached is an advance copy of an ACIN (Attachment 2) that you will be receiving
shortly which describes the key elements of the PCO plan amendment, including
eligibility, scope of benefits, and structure of the program. Attacment 3 is a side-
by-side comparison of the current IHSS Program, the PCO Program, and the
"Residual" IHSS Program. The major groups of current IHSS recipients and
services who would not be eligible for PCO (and hence eligible for the residual
IHSS Program) are Medi-Cal medically needy, domestic services, advance pay
clients, and clients with a "responsible relative" provider. Responsible relative is
being defined as a spouse or parent of a minor child recipient. Attachment 4
details some of the fiscal issues that will need to be addressed, most requiring
resolution prior to implementing PCO.
CWDA Executive Committee: President:Charlene A.Chase,Santa Barbara o Vice President at Large: William H.Gundacker,Kings
Executive Officer: Marsena A. Buck, Stanislaus o Secretary/Treasurer:Stephen D. Brohmer, Del Norte o Vice President of Administration:
Larry M.Leaman,Orange o Vice President of Program: Lee Rhyne, Madera o Vice President of Services:Gerard J. Lachaussee,Shasta
Los Angeles Representatives: Eddy S.Tanaka, Dept.of Public Social Services;Peter Digre, Dept.of Children's Services
Small Counties Representative: Jeannie Nix-Temple,Trinity o Legislative Chairman: Richard R.O'Neil,Sarna Clara
Federal liaison: Patricia Johnson Craig o Executive Director: Frank J. Mecca
Sacramento Office: 1010 11th Street • Suite 310 • Sacramento, CA 95814 • (916) 443-1749 • Fax (916) 443-3202
Washinq!on Office: 1701 K Street N.W. • Suite 200 • Washington, DC 20006 • (202) 466-0001 • Fax- (202) 331-7476
CWDA Workplan and Issues
It became clear at the kick-off meeting that there is a large number of s""gnificant
issues to be dealt with in a very short timeframe. Therefore, the workgroup
decided to meet weekly (beginning the second week in January) to review any
products from SDSS and to ensure an implementation plan that is of maximum
benefit to counties. We will have one more meeting before the holidays on
December 22.
In order to facilitate maximum communication within the Association, the
workgroup decided to add two (as yet unidentified) members so that the group
would have representatives from each of the regional committees of both the Adult
Services and the Fiscal Committees.
Some of the key issues that the group will be grappling with include:
♦ potential models for implementing PCO to ensure maximum county
flexibility;
♦ estimating the cost to counties to implement PCO in order to justify
full funding for .CSBG (a list of fiscal bullets developed by SDSS is
also attached);
♦ data processing requirements and CMIPS reprogramming;
♦ cash flow issues;
♦ the entitlement status of the IHSS residual program
Interim Implementation
Several counties have already indicated that they are ready or close to ready to
implement PCO. The SDSS is interested in discussing implementing PCO in
several counties prior to April 1. If, after reviewing the attached materials, you are
interested in exploring the possibility of being an early implementation county, you
should contact Bob Barton at SDSS.
If you have any questions or concerns, you may contact anyone on the workgroup, or
give me a call at CWDA.
CWDA - Personal Care Option Workgroup
NAME COUNTY PHONE PROGRAM/REGION
Buck, Marsena Stanislaus 209 525-6719 Director
Clark Ken Orange 714 541-7766 Fiscal - Southern
Decker, Mike S. Bernardino 909 387-2402 Program - Southern
Edwards, Dianne Orange 714 541-7776 Program - Southern
Fabella, Danna Sonoma 707 527-2459 Program - Bay Area
Fitzgerald, Barb Ventura 805 652-7621 Fiscal - Southern
Gallagher, Kathy S Clara 408 441-5600 Program - Bay Area
Glassey, Allison Mendocino 707 463-1879 Director
Hunt, Jim Sacramento 916 366 4275 Fiscal - Valley
Michaelson, John S. Bernardino 714 387-4764 Director
Noda, Mike Yuba 916 741-6364 Program - Northern
Pettygrove, Scott Stanislaus 209 525-4860 Program - Valley
Riley, Barbara Placer 916 889-7620 Fiscal - Northern
Rinaldo, Yolanda Sonoma 707 527-2156 Director
Silva, Charlene San Mateo 415 573-3904 Program - Bay Area
Takeda, Julia LA DPSS 310 908-8374 Program - Southern
Watts, Linda Solano 707 421-7294 Program - Bay Area
Yamasaki, Mindy Sacramento 916 732-4077 Program - Valley
Missing - Representative from Bay Area Fiscal - to be named
r
r.
Advance
STATE OF CALIFORNIA-HEALTH AND WELFARE AGENCY
DEPARTMENT OF SOCIAL SERVICES :y :Y
744 P Street, Sacramento, California 95814 +
ALL COUNTY INFORMATION NOTICE NO. 1-66-92
SUBJECT: MEDICAID FUNDING OF THE IN-HOME SUPPORTIVE SERVICES
(IHSS) PROGRAM
The purpose of this letter is to transmit a copy of IHSS
legislation recently passed and to inform you of the preliminary
planning on the Personal Care Option (PCO) . While activities at
the State level are in an early stage, we anticipate much
interaction with counties on PCO planning, beginning with a meeting
with County Welfare Directors Association (CWDA) representatives
which has been scheduled for December 11, 1992 . PCO programs must
be approved by Department of Finance (DOF) and cost neutral to the
State and counties before implementation can proceed. However, we
believe it is important for counties to begin to consider their
needs and probable costs associated with future implementation. We
hope that this advance notice will allow you to anticipate the
implications of implementation of PCO.
Chapter 939 , Statutes of 1992 (AB 1773 , Moore) , was filed on
September 28, 1992 (see Attachment A for reference) . This bill
required the State Department of Health Services (DHS) to submit a
State Plan Amendment (SPA) to include a portion of the IHSS Program
as a covered service under Medi-Cal as a medicaid PCO. Both
Program and administrative costs are subject to medicaid
reimbursement. Implementation of the PCO changes are dependent
upon Health Care Financing Administration (HCFA) approval of the
SPA and DOF certification that PCO, as approved by HCFA, is cost
beneficial to the state and counties.
DHS submitted the SPA to HCFA and it was approved November 2 , 1992 .
The following summarizes the changes proposed in the SPA and
identifies areas where counties should begin planning. Once
decisions have been made about program format, there will be an
urgency to quickly implement the PCO.
2
BASIC ELIGIBILITY CRITERIA FOR PCO
PCO eliqibility will be limited to categorically eligible Medi-Cal
recipients (cash assistance recipients) who have a disabling
condition that is permanent or chronic in nature and which is
expected to persist at least twelve months or end in death. We
intend to presume that all recipients who receive SSI/SSP meet this
disabling condition requirement. Any other cash assistance
recipient who does not qualify for SSI/SSP must be evaluated by a
physician and the county to determine whether he/she qualifies
based on this disabling condition criteria. The applicant has a
qualifying disabling condition if he/she has verified medical or
psychiatric diagnosis for a condition which has lasted at least 12
months or is expected to last at least 12 months or end in death
and is severe enough to create a mental impairment in memory,
orientation and/or judgment such that the sum of the mental
function scores equals or exceeds 7, or functional impairment rank
of 3 or more in at least one of the following:
a. mobility inside
b. bathing and grooming
c. dressing
d. bowel, bladder and menstrual
e. transfer
f. eating
g. respiration
IHSS income eligible recipients will not be eligible for funding
under the PCO, but will continue to be eligible for IHSS.
NEED CRITERIA
Recipients eligible for PCO will be those who require one or more
personal care service activities, protective supervision or
paramedical services. If the recipient qualifies for PCO funding,
all services he/she is authorized to receive will be eligible for
.,medicaid reimbursement. Recipients needing only domestic and/or
related services will continue to be eligible for IHSS.
PCO ELIGIBILITY BASED ON RELATIONSHIP OF PROVIDER
Recipients whose provider is a legally responsible relative will
not be eligible for funding under the PCO, but will continue to be
eligible for IHSS. Legally responsible relatives excluded from PCO
funding are the recipient's spouse when the recipient is legally
married and the recipient's parent (by birth or adoption) when the
recipient is an unemancipated minor (under the age of 18) .
PHYSICIAN'S CERTIFICATION
The case files of those recipients eligible for PCO reimbursement
must have a statement of medical necessity for personal care signed
by a physician. Physician recertification must occur annually.
ti. .
3
In preparation for potential retroactive Title XIX claiming for the
period following DOF approval of the statewide program, counties
may want to identify records of those clients who are likely to be
funded by PCO funds which have a current medical certification
form. Qualifying medical certification forms must be less than 12
months old and must recommend personal care._ SOC 321s which
authorize paramedical services will also meet this requirement if
the form was completed within the last 12 months.
If the county chooses to solicit medical reports from physicians
documenting medical necessity, forms could be sent through
recipients to their doctors where needed. At county option, the
physician certification might be done by the recipient's treating
physician or another physician who has reviewed the necessary
paperwork.
County IHSS staff will continue to use the Uniformity assessment
criteria and apply IHSS regulations and standards in aF--jessing
recipient needs for PCO and authorizing services.
NURSE SUPERVISION
HCFA requires that the PCO services be supervised by registered
nurses (RNs) . The RN supervises the plan of treatment and,
periodically, must visit' each PCO recipient to monitor the
recipient's condition and the effectiveness of PCO services.
Nursing supervision must be available in order for a county to
transition cases to PCO.
CDSS intends that counties have maximum flexibility in determining
how the nursing supervision will be available to the caseload. The
county may hire RNs as CWD staff, may arrange for nursing
supervision through an interagency agreement with the county Health
Department or may contract or otherwise arrange for the nursing
supervision through contracts with an agency or individual (s.) . _
MODE SELECTION
We anticipate that all current mode choices will be allowable
within the PCO. In addition, county authorities and consortia
described in SB 485 will be options available to counties.
Counties are encouraged to seek flexible and creative program
solutions which maximize program effectiveness and cost
efficiencies. Enhancements to the IHSS Case Management Information
and Payrolling System (CMIPS) are contemplated, in order to
facilitate monitoring of the homemaker services mode.
PROVIDER QUALIFICATIONS
All providers of PCO services must be enrolled as Medi-Cal
providers. The employer of providers, in all modes other than the
IP mode, will be enrolled and will be required to sign documents
acknowledging federal requirements and must keep adequate audit
trail for federal review. Instructions will be issued which define
"adequate audit trail. "
4
Individual provider enrollment will probably be supported by CMIPS.
At a minimum, IPs must demonstrate competence to perform authorized
PCO services to be eligible for enrollment as a PCO-IP. All IPs
providing IHSS at the time of conversion to PCO or within 30 days
of a county's conversion will be considered grandfathered-in as
competent to be enrolled providers. Thereafter, recipients or
persons legally authorized to act on behalf of recipients, will
attest to the IP's competence. However, the county shall intervene
in the event that the recipient has been neglected or abused by the
action or, inaction of the provider. IPs will be required to sign
a statement of vendor compliance and recertification with each
timesheet which acknowledge that the IP is subject to federal
audit. Camera-ready copies of these forms will be available to
counties as soon as administratively feasible so that counties can
get a head start in enrolling providers if they choose.
ADMINISTRATIVE PROCEDURES
We intend to work with counties to develop a system which is
flexible in allowing for a variety of county operational
configurations while processing all the federally required data
elements through CMIPS in support of the Medi-Cal computer system
(MMIS) . Our goal is to have the differentiation between IHSS and
PCO virtually invisible at the delivery level.
The county will continue to be required to keep track of units of
services authorized and provided. The SPA defines a "unit of
service" as an hour of service.
CWDA INVOLVEMENT
We are developing procedures, drafting regulations and forms and we
believe that county involvement in every phase of that planning is
essential to make the process optimally operational. We will share
drafts with CWDA Adult Services, Fiscal and EDP Committees and
Adult Services Regional Committees and request CWDA to delegate
representatives state staff can contact for expedited review and
advice.
FISCAL CLAIMING
Time study and claim instructions will be developed in conjunction
with the CWDA PCO workgroup(s) . Upon completion of the PCO design,
time study and claim instructions will be transmitted to counties
in a County Fiscal Letter. Questions regarding time study and
fiscal claiming should be directed to the Fiscal Policy and
Procedures Bureau, at (916) 657-3440.
RESTORATION OF CUTS
AB 1773 specifies that once DOF has determined that the additional
FFP generated by PCO is sufficient to cover state and county cost
of fully funding the IHSS and PCO programs, that CDSS will
authorize restoring services reduced by SB 485. That restoration
will be generated automatically by CMIPS.
t.
I .
5
TRAINING
Adult Services staff plan to conduct statewide training on the
implementation of PCO prior to implementation.
Questions about this letter or issues about PCO or other changes
included in AB 1773 should be directed to Mr. Robert A. Barton at
(9 16) 657-2143 .
]A;dul
MESFandFamily
BROWN VIRGIL J. TONEY
tingputy Director Division Chief
Services Medi-Cal Benefits Policy
Division
cc: CWDA
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DEPARTMENT O,F SOCIAL SERVICES
DEPARTMENT OF HEALTH SERVICES
JOINT WORKPLAN
PERSONAL CARE OPTION
Target
Task Date
o Prepare All—County Letter ( DSS)
— provides basic program description 11 /13/92 to DOF
— to DOF with updated estimates
— release to counties after DOF review 11 /30/92
— intended to enable counties to prepare
for initial transition to PCO
o Interagency Agreement with DHS to clarify 11/ 13/92 Draft
and coordinate responsibilities for : ( DSS/DHS )
— regulation development
— systems modifications
— provider agreement statement
— reporting requirements
— county plan approval process
— cost control process
— third party liability
— execute agreement 12/20/92
o Draft emergency regulations ( DSS/DHS) 11 /30/92
( minimal requirements )
— eligibility criteria 12/30/ 92
— physician/nurse review
— nursing standards
— provider enrollment
— documentation standards
— implementation
— quality assurance
r — caseload stanaards
— county/advocate review of DSS draft regulations 12/ 14/92
— file regulations ( DHS/DSS) 2/ 1 /93
o Prepare fiscal instructions for counties 1 / 15/ 93
o Develop and provide training for counties 1 /30/ 93
o File emergency regulations 2/ 1 / 93
o PCO implementation 2/ 1 /93
o CMIPS Wor kgroup
— determine minimal elements required to meet 11 /30/92
HCFA requirements
— meet with - HCFA 12/ 14/92
— amend EDS contract
— develop forms , procedures , reprogram
test system
implement system 4/ 1 / 93
obtain HCFA approval of system 6/30/ 93
o Establish QC/Monitoring of PCO _ 6/ 30/ 93
CWDA PERSONAL CARE OPTION (PCO)WORKGROUP
FISCAL BULLETS
FISCAL GOALS
o Maximize federal financial participation (FFP) for the In-Home
Supportive Services (IHSS) Program
o Provide a stable funding base for the necessary services to
prevent persons from being institutionalized.
o Ensure that there is no disruption to the payment of service
providers.
PCO DESIGN
o Persons eligible for PCO must be categorically eligible Medi-
Cal recipients who have a disabling condition that is
permanent or chronic in nature and expected to persist at least
twelve months or result in death.
o Physician certification for client's plan of treatment will be
required and must be maintained as part of the case file.
o The plan of treatment must be supervised by a registered
nurse. CDSS will pursue claiming this person as a skilled
professional medical personnel, in accordance with 42 CFR
432.50 (d), at an enhanced FFP rate.
o An assessment for service needs must be performed for the
client. The IHSS uniform assessment will be used for this
purpose.
o The assessment process needs to ensure a uniform
identification of service needs, so that PCO clients with the
same medical need receive the same number of hours and same
medical services.
o A registered nurse will be required to review the plan of
treatment periodically in conjunction with an assessment of
the recipient's health, quality of personal care services being
provided, and the client's need for continued care.
12/11/92
o The PCO service providers will be enrolled as Medicaid
providers and must be certified to be physically capable to
provide the authorized services. For the purposes of PCO each
individual provider, and contractor by provider and county, will
be considered a provider.
o Department of Health Services (DHS) is mandated to establish
rates for Medicaid services that are adequate. In order to meet
this mandate, DHS must conduct a public hearing on the rate
methodology to be used for PCO service providers.
o Service providers who are the recipient's spouse when the
recipient is legally married or the recipient's parent, in the
case of a minor child, will not be eligible for Medicaid funding
under PCO. Recipients receiving advance pay and/or have third
party insurance coverage will not be claimed under PCO at this
time.
o To the extent required by federal Medicaid regulations, a
system for identifying and collecting payments for recipients
with other insurance coverage will be implemented.
o PCO services will be delivered via the IHSS Program service
delivery modes of welfare department staff, contracted
providers, and individual providers. Consortium, public
authorities, and others will be addressed on a case by case
basis.
o The Case Management Information and Payrolling System
(CMIPS) will be used to calculate and account for all PCO
service delivery modes.
o Federal approval will be sought and appropriate modifications
made to qualify CMIPS for enhanced FFP under Medicaid.
o Counties must diligently meet documentation requirements and
maintain adequate audit trails for PCO in order to minimize
the risk of Medicaid audit exceptions.
o A utilization review will be required for PCO.
2
I
I
U'.
t
12/11/92
FISCAL ASSUMPTIONS
o For PCO services costs, the State/County share of the
nonfederal share will be 65%/35%.
o For nonPCO IHSS Program costs the sharing ratio will be 65%
State/35% County for the total program costs.
o For IHSS and PCO administrative costs, the State/County split
of the nonfederal share will be 70%/30%.
o Our fiscal analysis assumes that the IHSS Program will not
incur caseload increases due to implementation of PCO.
o The total authorized personal care service hours cannot exceed
a maximum of 283 hours.
o Hours for existing IHSS cases elgible for PCO can only be
increased as a result of a reassessment based on medical
necessity.
o Provider costs per hour of service for PCO cases will not be
changed from the current IHSS Program.
o We anticipate additional cost for the physician certification
requirement under PCO. However, our studies indicate that
most of PCO eligible IHSS recipients are receiving Medicare
and Medi-Cal. We assume that the recipients personal
physician would complete the certification and directly bill
the appropriate program.
o CDSS will pursue enhanced FFP for the nurse supervision
function. We anticipate additional administrative costs for
counties to meet this provision for PCO.
o An interim system will need to be developed to capture the
PCO costs for counties that can provide PCO services from the
time PCO becomes operative to April 1 , 1993, the statewide
implementation date.
i
3
12/11/92
DISCUSSION ITEMS
o For claiming purposes we propose to eliminate the reporting of
all IHSS provider cc;sts (i.e., Homemakers, contract providers)
currently on the administrative expense claim. Counties would
instead submit an invoice, based on information from CMIPS, to
CDSS for payment of these costs.
o In accordance with Assembly Bill 1773, CDSS will restore the
funding associated with 12% service hour reduction for IHSS
recipients implemented October 1992. The funds would be
restored fully or in part, as soon as administratively
practicable. Restoration of the funds is conditional upon
sufficient General Fund (GF) dollars being projected to be
available and the projected GF is greater than the amount
expended for IHSS for FY 1992/93. CDSS will determine if
implementation of PCO will result in sufficient GF savings to
replace the program reductions. However, the services cannot
be restored until the Department of Finance has determined
that restoration of the services will not result in additional
costs to the state or county for FY 1992/93.
o CDSS will need to determine the cost impact on counties'
workload and staff due to implementation of PCO.
4
TO: BOARD OF SUPERVISORS
Contra
FROM: Phil Bachelor, County Administrator
Perfecto Villarreal, Social Service Director o! •►.:.��� ;z COSta
DATE: December 15, 1992 ' '. " Co1.1rty
rq.couK'�
SUBJECT: REDUCTIONS IN STATE FUNDING FOR CHILD WELFARE SER S
AND BUDGET REDUCTION PLAN - PHASE I
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
RECOMMENDATION(S):
1. ACKNOWLEDGE the projected overall $3.17 million budget shortfall in the Social Service Department,
primarily due to late notice on reduced funding allocations from the State and/or inadequately funded
State program mandates for administration of Child Welfare Services (CWS), In-Home Supportive
Services (IHSS), Foster Care Licensing, Adoptions, Food Stamps and Aid for Families with Dependent
Children (AFDC).
2. ACKNOWLEDGE that the State's current estimated FY 92-93 and FY 93-94 budget deficit of $9 - 12
billion increases the likelihood of even further State cuts to Social Service programs, and consequently,
the need for additional budget reductions.
3. EXPRESS grave concern over the devastating impact of the $1.6 million State reduction in CWS funding
on children's services in Contra Costa County, including the magnified impact of receiving the reduction
5 months into the fiscal year.
4. REQUEST that the Employee Organizations join the County in objecting to the additional state-imposed
funding reductions; in urging distribution of the $7 million State CWS reserve to counties who received
allocation cuts; and in supporting revision of the allocation methodology to minimize the possibility of such
wide funding variations in future years.
CONTINUED ON ATTACHMENT: _YES SIGNATURE:
d
RECOMMENDATION OF COUNTY ADMINISTRATOR_RECOMMENDATION OF BO RD MMITTEE
APPROVE OTHER
SIGNATURE(S):
ACTION OF BOARD ON a 99aAPPROVED AS RECOMMENDED Y OTHER
VOTE OF SUPERVISORS
I HEREBY CERTIFY THAT THIS IS A
Y UNANIMOUS(ABSENT LL ) TRUE AND CORRECT COPY OF AND
AYES: NOES: ACTION TAKEN AND ENTERED
ABSENT: ABSTAIN: ON MINUTES OF THE BOARD OF
SUPERVISORS ON THE DATE SHOWN.
Contact: Perfecto Villarreal, 313-1579 L )�aL� 4a
ATTESTED pAn__ _,�.�,
PHIL BACHELOR,CLERK OF
THE BOARD OF SUPERVISORS
AND COUNTY ADMINISTRATOR
ec: CAO
Social Service Dept.
Personnel Department
BY DEPUTY
5. DIRECT the County Administrator and Social Service Director to continue to work with the State
Health and Welfare Agency, Contra Costa's Legislative Delegation and the County Welfare Directors'
Association on these CWS funding allocation issues, including the need for more timely action by the
State. (See attached letters from the County Administrator's Association of California and the County
Administrator)
6. ACKNOWLEDGE the need to take immediate actions to resolve as much of the $3.17 million shortfall
as now possible ($1.96 million) in order to minimize even further program detriment resulting from
delays; AUTHORIZE the Social Service Director to apply projected savings in the Categorical Aids
budget to help mitigate the $3.17 million shortfall; and DIRECT the County Administrator and Social
Service Director to report back to the Board as soon as possible with further recommendations
necessary to balance the budget in fiscal year 1992-93.
7. RECOGNIZE that reductions in program overmatches are no longer an alternative to staff reductions,
due to previous budget actions, and that consequently, staff reductions are the direct result of actions
by the State to reduce the State budget.
8. In order to help mitigate the impacts of staff reductions:
• ADOPT the attached resolution offering early retirement to the classifications of Social
Casework Specialist II, Social Worker, Social Work Supervisor I, Social Work Supervisor Il,.
Children's Services Aides and Deep-Class Clerk for the period December 21, 1992 to
January 8, 1993.
• ESTABLISH 10 additional Eligibility Worker positions in the Medi-Cal program effective
January 14, 1993, in order to utilize newly available state and federal revenue, and DIRECT
the Social Service Director to offer these positions to Social Workers and Social Casework
Specialists affected by this budget reduction.
9. ADOPT the attached resolution reducing a total of 29.5 vacant and filled positions in the CWS and
IHSS programs, effective January 15, 1993 including reducing the number of caseworkers and
supervisors in Child Welfare Services from 157 to 142 (9.5%), which erodes Contra Costa's ability to
provide the most progressive children's services program in the state and reduces staffing levels at
only State funded levels.
10. DIRECT the Social Service Department to discuss with all employee organizations the ramifications of
the staff reductions required by the reduced State funding.
11. DIRECT the County Administrator and Social Service Director to continue to explore alternatives for
reducing the budget shortfall and the need for further layoffs including:
• increased departmental cost-effectiveness by helping families become self-sufficient through
a multi-departmental service integration approach.
• offering eligible laid-off employees positions in revenue-producing programs such as Medi-
Cal, as positions become available.
• continued negotiation with employee organizations on mandatory furlough, to save on net
county cost and preserve positions.
• continued use of voluntary furlough, part time , job sharing and leaves of absence in program
areas that will not cause a loss of Federal or State revenue.
• early implementation by the State of IHSS Title 19 personal care option funds to give the
counties access to federal funding (now anticipated in FY 1993-94).
12. MODIFY Resolution 92/624 relating to General Assistance (GA) staffing reductions to extend the
effective date from December 31, 1992 to January 15, 1993 to allow time for implementation of the
new transportation system for GA clients, to meet community concerns.
r.
BACKGROUND
Social Service Department Budget Shortfall
The Social Service Department is currently facing a $3.17 million budget shortfall for Fiscal Year 1992-93:
h II
(in millions)
Child Welfare Services $1.604
County Services Block Grant $.787
(IHSS)
Foster Care Licensing $.143
Adoptions $.246
Food Stamps $.225
AFDC $.114
General Assistance $.054
Administration
TOTAL $3.173'
The projected shortfall is caused in large part by unexpected reductions in State funding allocations in
Child Welfare Services, Community Services Block Grant (CSBG), and welfare program
administration. Partly as a result of the very late adoption of the State Budget, the Department was
not notified of these funding reductions until very late in the fiscal year. For example, the State
Department of Social Services did not notify the Department of the $1.6 million Child Welfare Services
reduction or the CSBG reduction until November, five months into the fiscal year.
The Department and County Administrator have made concerted efforts through the County Welfare
Directors Association and the State Health and Welfare Agency to restore, partially or completely, the
Child Welfare Services funding. These efforts have not been fruitful, with the exception of the
probable release of an estimated $7 million in CWS funds now being held in reserve by the State.
This release could restore $210,000 for Contra Costa County.
In addition to the State funding reductions, the implementation of General Assistance Centralization
has been delayed from October 1992 to January 9, 1993, causing cost increases in General
Assistance administration. The target date was extended to allow the Department to address
community concerns related to transportation. The Department has issued a Request for Proposal to
private transportation companies to provide services to West and East County General
Assistance/Food Stamp applicants.
The Department proposes to begin addressing the budget shortfall through the Phase I actions listed
below:
In millions
Recognition of
Restored CWS funding $•210
Application of
Categorical Aids $.950
Surplus
Staffing Reductions
;E.B00
TOTAL $1.960
'This does not include a potentially significant audit adjustment for audit exceptions dating
back to fiscal year 1983-84.
This leaves a shortfall of $1.213 million to be solved. The County Administrator and Social Service
Director will continue to explore all possible alternatives to further staff reductions in order to resolve
the projected shortfall, including:
A. Increased cost-effectiveness of helping families in crisis through service integration.
B. Increased federal revenue through implementation of IHSS Title 19 personal care
funds now anticipated to be available in FY 93-94.
C. Further streamlining of General Assistance operations.
D. Streamlining the department's interactions with Juvenile Court.
E. Implementation of mandatory furlough, and continuation of voluntary furloughs, leaves
of absence and job sharing.
State Budget Reductions
This funding shortfall is part of the continuing fall-out from last year's record-setting State deficit of
approximately $11 billion. For fiscal years 1992-93 and 1993-94, the State is already projecting an
unprecedented budget deficit estimated to range from $9 billion to $12 billion. The State economic
outlook continues to be very dim, with unemployment increasing to 10.1% last month. As the State
begins to address its budget deficit, we can expect health and welfare programs to again be targeted
for reductions.
Staffing Reductions
During previous budget reductions, the Board has followed a policy of minimizing the impact of budget
reductions on children's services. The State's actions have rendered that goal unattainable for fiscal
year 1992-1993. Listed below are the positions which the department proposes to eliminate as part
of the first phase of budget reductions:
Classification CWS - CWS - IHSS/Referral Unassigned
Filled Vacant Filled Vacant
Social Casework 13 1.5
Specialist
Social Work 3 1
Supervisor
Social Worker 5
Parent Aides 3
Clerks 2 1
TOTAL 21 1.5 6 1
Comparative Management, Administrative, and Line Staff Reductions
The Department has previously reduced line administrative and managerial positions by almost 46
per cent since 1986-87. With the line services reductions included below, a net gain of 92.2 line
positions has occurred since that time.
STAFFING COMPARISON 1986-87 TO 1993
(FiF,ed,,Fud-Time Equivalents)
Actual Proposed Percent Change from
1986-87 Current 1/15/93 2 86-87
Management3 37.00 21.00 20.00 -45.95%
Administrative 63.70 40.00 40.00 -37.21%
Line Supervisors5 90.00 96.00 91.00 +1.11%
Line Workers 693.90 805.00 786.10 +13.29%
TOTAL 884.60 962.00 937.10 +5.93%
Line Worker Subtotals
Clerical 242.8 216.25 209.75 -13.61%
Eligibility 252.10 356.60 365.60 +45.02%
Social Caseworkers 100.20 143.95 130.95 +30.69%
Social Workerss 70.30 73.70 68.30 -2.84%.
Fraud Workers 7.50 6.50 6.50 -13.33%
Other? 21.00 1 8.00 5.00 1 -76.19%
TOTAL 693.90 1 805.00____J.186.10 +13.29%
Impact of Reductions on Programs and Service Levels
The staff reductions decreasesChild Welfare Services caseworkers and supervisors by 9.5%, from
157 to 142. This will impact Children's Services operations and program delivery with increases in
workload, up to State funded levels. These reductions will be implemented by taking immediate
action to reduce specialization within CWS in accordance with State regulations. This includes
consolidation of the Emergency Response Screening Unit; the specialized court unit; Children's
Residential Placement Unit, the Specialized Placement Program, the Lion's Gate Liaison Unit; the
Absent Parent Search function; and Parent Aides function. Many of the functions performed by
these units will now be performed by the caseworkers. However, this plan achieves and sustains for
the rest of the fiscal year the State-funded staffing guidelines for Child Welfare Services.
The reductions in the In-home Supportive Services program will mean an increase in average
caseload from 243 to 270 per worker which is consistent with caseloads in comparable counties.
This will slow down the processing time for applications, increase the challenge of meeting the 30-
day timeline required by regulation, and will impact the ability of the Department to provide services to
the aged and disabled and to monitor appropriate payments to providers.
2Includes reductions effective 12/31/92 previously ordered by Board.
3Includes Director, Assistant Directors, Division Managers, Personnel
Officer, Systems Officer, Office Managers, Executive Assistants, EW Sup II, AAA
Director, Welfare Fraud Manager.
4Includes AAA Staff Assistants, Administrative Analyst series, Personnel
Analysts, Dept. PC Coordinator, Program Specialists and Program Analysts,
Systems Analysts, Appeals Officers, Secretaries, Data Operations Specialist,
Pre-Hearing Review Specialist.
5Includes Clerical, Eligibility, Welfare Fraud, Social Work, Vocational
Supervisors, Volunteer Program Coordinators.
6Includes Social Worker level positions and SSPA's.
Includes Assistant Volunteer Coordinators, Aide classes, former Storekeeper.
5
A
The Department reduction plan will have particular programmatic impact on Information and Referral.
The reduction in staffing from 1.0 FTE to .5 FTE in the Information and Referral service will mean a
reduction in generic social services referrals that can be provided to the general population.
The remaining $1.21 million budget deficit for FY 92-932 is being reviewed by the County
Administrator and the Social Service Department, who will return to the Board as soon as possible
with further recommendations for consideration.
E
Z.
ATTACHMENT A
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
RE: Abolishing Positions and )
Laying Off Employees in the ) RESOLUTION NO. 92/861
Social Service Department )
The Contra Costa County Board of Supervisors in all of its capacities as the governing body of
this County and of the Districts and Agencies of which it is the governing body, RESOLVES
THAT:
1. The Board has considered the financial impact in the Social Services Department of State
revenue reduction, and has considered the staff retention plan submitted by the
Department.
2. In order to keep expenditures within available funding to the extent possible, it is
necessary to abolish the positions described in the lists attached hereto in the interest of
economy or because the necessity for the position (s) involved no longer exists, and to lay
off employees accordingly. Said lists are incorporated herein by reference, and said
positions are hereby abolished effective on the dates indicated thereon.
3. The Director of Personnel shall prepare lists showing the order of lay-off for affected
employees.
4. The County Welfare Director shall issue layoff or displacement notices, as the case may
be, and give notice to the affected employees of the Board's action.
5. The Employee Relations Officer shall give notice of this Resolution to recognized employee
organizations representing employees impacted by this action.
6. To the extent that the subjects of this Resolution are within the scope of representation
under the Meyers-Milias-Brown Act(Government Code Section 3500 et seq.), this Board
offers to meet with any recognized employee organization upon request concerning this
Resolution.
7. Recognized employee organizations may submit to the Employee Relations Officer written
requests to meet and confer on specific proposals with respect to the Resolution or any
resulting layoffs. This authorization and direction is given without prejudice to the Board's
right to reduce or terminate the operations and services of the County and of Districts
governed by this Board and to eliminate classes of employees or positions as involving
the merits, necessity, or organization of services or activities of the County or districts
governed by the Board and not within the scope of representation.
8. This action is taken without prejudice to pending consulting, meeting, and meeting and
conferring with employee organizations.
I
RESOLUTION NO. 92/861
1 ,
Attachment A
Page 2
BE IT BY THE BOARD RESOLVED that the followinq positions be canceled effective
January 15, 1993 at the close of business.
Class No. Vacant/
BU# DeFartment Ora# Code Classification Pos. # Canc. Tilled
0500 Social Serv. 5400 JWXB Clerk-Exp Level 02119 1 V
5400 JWXB Clerk-Exp -Level 00450 1
5300 JWXB Clerk-Exp Level 01934 1
5204 XDWB Child.Svc. Aide 01804 1
5300 XDWB Child.Svc. Aide 01702 1
5400 XDWB Child.Svc. Aide 01698 1 . 5
5400 XDWB Child.Svc. Aide 01700 1 . 5
5300 XOHA Soc.Wk.Sup II 01572 1
5200 XOHA Soc.Wk.Sup.II 00120 1
5204 XOHA Soc.Wk.Sup.II 00114 1
5204 XOHB Soc.Wk.Sup. I 00123 1
5400 XOVS Ron.Casewk.Sp. II 01413 1 V. 5
5400 " " " 01944 1 V
5204 " " " 01949 1
5204 " ^ " 01951 1
5400 " " " 01849 1
5400 " " " 02005 . 1
5202 ^ " " 02002 1
5400 ^ " " 01690 1
5204 " " " 00312 1
5300 ^ it It 00933 1
5300 " " to 01946 . 1
5300 " " It 00315 1
5400 " " of 00207 . 1
5300 " " Of 01950 -1
5202 XOWB Soc.Casewk.Sp.I 00910 1
5204 XOVC social Worker 01142 1
5300 XOVC Social Worker 00936 1
5204 XOVC Social Worker 00934 1
5201 XOVC Social Worker 01904 1
5300 XOVC Social Worker 00157 1
NOTE: Positions listed are full time unless otherwise noted.
PASSED UNANIMOUSLY BY BOARD MEMBERS PRESENT. (Supervisor Fanden was absent)
I hereby certify that this is a true and ccrrect copy of
an action taken and entered on the minutes of the
Board of Supervisors on the date shown.
1�,��..,�DJ .2 2fi
ATTESTED:
PHIL BATCHELOR,Clerk of the,3ocrd
of Supervisors and County Administrator
By
REOLUTION NO. 92/861
ATTACHMENT B
Adopted this Order on December 22, 1992 by the following vote:
AYES: Supervisors Powers, McPeak, Torlakson and Schroder
NOES: None
ABSENT: Supervisor Fanden
ABSTAIN: Noen
SUBJECT: EARLY RETIREMENT RESOLUTION N0. 92/862
The Board of Supervisors of Contra Costa County RESOLVES THAT:
I . By Ordinance 76-63 the Board of Supervisors has adopted the
provisions of Government Code section 31641 . 04, permitting early
retirement service credit.
II . Because of an impending change in the manner of performing
certain services in the Social Service Department, and in order
to achieve savings in money and other economic benefits for the
County, the best interests of Contra Costa County will be served
by permitting additional service credit for certain members of
the Contra ; ,;Co,stp� ;-County,.;-, Employee' s Retirement Association
(members)' .as -f o-lLows;:.;-.. to uv,,�
a. The. pro visLons�:;o.f�,j-,this resolution are applicable to all
members••. -,,emp•1-oyedv1:;;411 i ft the department(s) in the job
classification(s) designated on the attachments of this
.-resolution, whi.ch,._are_ .incorporated herein by reference.
b. Every eligible member who retires between December 21, 1992
and January 8, 1993 shall receive two additional years of
service credit for Contra Costa County service.
c. Upon demand by the Retirement Association, the County Auditor
shall transmit to the Retirement Fund the amount(s)
determined by the Retirement Board to be the actuarial
equivalent(s) of the difference(s) between the allowance(s )
theeligible member(s) receive(s) after getting the
additional service credit hereunder and the allowance(s) the
member(s) would have received without such credit.
d. On later re-entry into County employment under circumstances
otherwise requiring or permitting membership in the
retirement system, any member who has received additional
service credit hereunder shall forfeit such additional
service credit, and the County's payments hereunder shall be
refunded, unless the re-entry is the result of a temporary
call-back limited to the maximum hours of service in any one
calendar or fiscal year as provided by State law.
e. Provided, nevertheless, that the provisions of this
Resolution are not applicable;
1 . To any member otherwise eligible if such member
received any unemployment insurance payment within
six months prior to January 8, 1993.
2 . To any member if the member is not eligible to retire
without additional service credit under this Resolution.
Orig. Dept: Social Service Department
cc: Director of Personnel
Retirement Board
County Auditor-Controller
County Administrator
County Counsel
RESOLUTION NO. 92/862
Early Retirement December 21, 1992-January 8, 1993 Attachment B
Department: Social Services Department
Classifications :
XDWB Childrens ' Services Aide
JWXB Clerk (Experienced Level)
JWXC Clerk (Senior Level)
JWXD Clerk (Specialist Level)
XOVB Social Casework Specialist II
XOVC Social Worker
XOHB Social Work Supervisor I
XOHA Social Work Supervisor II
I hereby certify that this Is a true and correct copy of
an action taken and entered on the minutes of the
Board of Supervis on the date shown.
ATTESTED:
PHIL BATCI LOR,Clerk of the Board
of Supervisors and County Administrator
BY -- 1 Deouty
RESOLUTION NO. 92/862
County Administrator r.,-,ontra Board of Supervisors
Tom Powers
County Administration BuildingCO�+{� 1st District
651 Pine Street.11 th Floor Costa Nancy C.Fanden
Martinez,California 94553-1229 County 2nd District
(510)646-4080
FAX:(510)646-4098 Robert Schroder
3rd District
Phil Batchelor _ Sunne Wright McPeak
County Administrator t = 4th District
Tom Torlskson
5th District
November 12, 1992
Russell S. Gould, Secretary
State of California
Health and Welfare Agency
1600 Ninth Street, Room 460
Sacramento, CA 95814
Dear Mr. Go d:R V-11*4
I am writing this letter to.express my serious concern over the negative impact of the
proposed FY 92-93 Child Welfare Services (CWS) allocation on our ability to operate an
effective children's services delivery program.
We received notification of a $1,600,000 reduction in our overall CWS allocation from the
previous year. This reduction, coming five months into our fiscal year, would have a
disastrous impact on Contra Costa County's Child Welfare Services program. If one looks
at the State General Fund share, which is capped with no entitlement funding, our total
reduction Is 22%.
At the same time, Contra Costa County's allocation was cut, counties which accumulated
surpluses in 91-92 were given significantly higher allocations in FY 92-93. In reviewing
the county case counts that drive the allocations, it is apparent that the growth patterns
of the CWS components vary significantly from county to county. To the extent that the
latitude allowed in program practice will impact case counts, then the likelihood that this
variance in case counts is a reflection of differing program practices as opposed to
demographically related growth or decline, these counts would have been artificially
skewed. It is incumbent on the State to insure that data upon which these case counts
and allocations are based are consistently and equally derived throughout the State.
Russell S. Gould
page 2
November 12, 1992
A related issue is the potential impact the implementation of SB 1125 (effective in
September, 1992) will have on county operations, particularly as cases were previously
categorized as ER, FM, FR and PP. The entire basis upon which the allocation is
predicated will be completely changed three months into the fiscal year. Despite the
disclaimer in the DSS overview, there is bound to be some impact on the "mix" of case
counts, both within a county and from county to county. It does not seem prudent or
appropriate to totally ignore this impact by applying or overlaying an outdated allocation
criteria on what is essentially a new program.
As a means of alleviating the inconsistencies and minimizing the damage done by the
proposed allocation process, I strongly urge you to consider the modification of this
formula by the following features:
• A stop loss/gain be applied to minimize loss and limit increases received by
counties. This would be applied in the form of some percentage - ten or
fifteen percent.
With this modification, counties that are caught on the down side of a
formula change would have some time to prepare a more orderly downsizing
of personnel and cost. Likewise, counties receiving large windfall increases,
who are probably not in a position to spend their funds, would be able to
more effectively plan and implement an expansion program. This stop loss
has been used in prior CWS allocations and is currently part of the FY 92-
93 Licensing and Adoptions allocations.
• There needs to be a certification process whereby a county guarantees it
will expend a level of funds generated through an allocation. This will
identify any level of surplus not earmarked for expenditure by any county
that is unable or unwilling to expend a certain level of allocation. Statewide
surpluses may then be set aside for redistribution to counties needing
additional funds as identified through their certification. It is important that
this process occur as early as possible within the fiscal year.
The above recommendations are not new concepts and have been and are still being
used with success in ongoing allocations. I believe they should be an integral part of any
allocation methodology that produces significant year—to—year swings in funding via the
application of a purely caseload driven formula.
At this time, to stay within the numbers justified by the proposed allocation, we
would have to make in excess of a 20% reduction in our CWS workforce. A
reduction of such magnitude will result In a serious disruption of service. On the
other hand,it does not seem realistic to expect that counties that experience huge increases
Russell S. Gould
page 3
November 12, 1992
in their allocations and resultant authorized staffing levels will be in a position to hire and
have on board such a large number of staff in the remainder of the fiscal year. While
recognizing that surplus funds are eventually allocated,this process occurs after the close
of the fiscal year. Due to the uncertainties involved in a county not knowing, ahead of
time, what the collective surplus will be, we cannot afford to gamble with maintaining a
higher level of staff that may or may not be covered by an after-the-fact reallocation of
surplus funding.
urge you to seriously consider these recommendations as a means of correcting what
I consider to be a flawed allocation formula. I am certain that it is not your intent to place
undue hardships on counties that experienced severe loss of revenue by this proposed
allocation. We simply cannot operate from year to year not knowing the extent to which
our allocation may or may not be reduced in a subsequent year. Also, I urge you to
restore the proposed reduction of $1,600,000 to our CWS allocations for this fiscal year
to avoid very damaging impacts on the operation of Contra Costa's Child Welfare Services
Program.
Sincerely,
Phil Batchelor
County Administrator
cc: County Board of Supervisors
Eloise Anderson, Director SDSS
Charlene Chase, President CWDA
Frank Mecca, Executive Secretary-CWDA
Perfecto Villarreal, County Welfare Director
State Legislators
W gould.ltr
�L,N1STRL4r,yF L'ountj
c4lsoalatlon of Lafl oar to
OFDecember 10, 1992
Russell Gould, Secretary
State Health & Welfare Agency
1600 9th Street
Sacramento, CA 95814 _
Dear Secretar�ould:
At their Annual Meeting last week, the County Administrative
Officers Association of California (CAOAC) voted unanimously to
authorize me to express to you their dismay at the manner in which
the development of the 1992-93 Child Welfare Services funding
formula was handled by the Department of Social Services .
It is our distinct impression that the 1992-93 formula was
developed unilaterally, with no advance consultation with the
counties . Counties were not even advised in a timely manner of the
impact of the formula. It was only several weeks after the State
Budget was adopted and at least one full quarter of expenditures
were incurred by counties that our Social Services Directors were
advised, in effect, that many counties were going to receive
substantially less Child Welfare Services funding for 1992-93 .
Most counties had just completed or were in the final stages of
adopting their own budgets and making massive reductions to their
programs, including laying off hundreds of employees. To complete
that most . painful process and then be told - again without any
prior notice or consultation - that the Child Welfare Services
allocation to the county would again be reduced is simply
inconceivable.
Russ, this is not the type of process we have come to expect from
you and we hope you were unaware of the manner in which this
notification was being provided to the counties . We would ask that
you look into what happened in this case, determine whether
anything can be done to reverse this decision and then let us know
how this happened and what, if anything, you are able to do about
it. We have great confidence in the sensitive, candid and
forthright manner in which you have dealt with counties in the
past. We look forward to some explanation of what happened and
I
1100 K Street,Suite 101 0 Sacramento,CA 95814 0 (916)327-7500 0 FAX (916)441-5507
Russell Gould
December 10, 1992
Page 2
what could be done by our organization to undo the damage which
will otherwise be done to nearly every county Child Welfare
Services program in California if this decision is not reversed
immediately.
Very truly yours,
Phil Batchelor, President
County Administrator, Contra Costa County
PB:amb
ph1112-5 _
cc: Steve Swendiman, Executive Director
California State Association of Counties