HomeMy WebLinkAboutMINUTES - 01121993 - 1.51 Independent RECEIVED
C. Living II DEC 7
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December 4, 1992 CLERK BOARD OF SUPERVISORS
CONTRA COSTA CO.
Board of Supervisors
Contra Costa County
651 Pine Street, Room 106
Martinez, CA 94553
0
Dear Supervisors:
On behalf of the staff and the Boarcb of Directors at the
Independent Living Center, for Contra Costa and Solano counties,
I want to personally thank the Board of Supervisors, for their
decision not to contract with outside, for profit care provider
agencies. o
The " Individual Provider Mode" of coordinated care affords the
disabled and elderly consumers the basic right to coordinatetheir
own care. This has positive impact in avoiding the unnecessary
institutionalization of the consumers we serve.
s
Due to the twelve percent funding cuts in In-Home Support Services Y
and the availability of Title 19 funds, Independent Living Resource
and other concerned service agencies would like to- address this
issue at your Board Meeting on January 12, 1993.
•
We request that the County Supervisor's clerk provide ILR with a
copy of your agenda for the January 12 Meeting. Again, thank you!
Sincerely,
ANNE BEST
xecutive Director •
1 Copy - Each Supervisor
1 Copy - Clerk's Office
CC: BOARD MEMBERS (Provided)
o o
•
•2637 Pleasant Hill Road • Pleasant Hill, CA 94523 0
(510) 935-4571 • Voice I TDD 935-4571
j DATE:
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Y
Social Service Department Contra Please reply to:
1305 Macdonald Avenue
James A.RydingswOrd CostaRichmond,California 94801-3120
Director s
County ❑ 3630 San Pablo Dam Road
EI Sobrante, CA 94803-2730
❑ 3431 Macdonald Avenue
e s•__,c_•of Richmond,California 94805-2184
❑ 3045 Research Drive
Richmond,California 94806-5206
srq•coun`�
January 12, 1993
Members of the Board of Supervisors
Contra Costa County
County Administration Building
651 Pine Street
Martinez, CA
Dear Chair:
Today is the last opportunity for you to ,take action to reverse your
decision of December 22, 1992 authorizing the layoff of approximately thirty (30)
filled Social Service positions. There are compelling reasons why you must
reverse your decision of December 22.
There is sufficient funding available for these positions!
On April 1, 1993, a statewide infusion of Title XIX, Medicaid funding will
begin which will pick up 50 % of the costs the counties had previously paid for
both the salaries of In-Home Supportive Services staff and for the payroll of the
attendants who provide those services in the home for the disabled and the frail
elderly. When this Personal Care Option becomes available statewide on April 1,
1993, it will also be required that the counties restore the 12% decreased from
providers' salaries this fall as mandated by legislation accompanying the adoption
of the budget. In its budget allocation Contra Costa had already provided for
this restoration, making this a non-issue for implementation of the program.
What Contra Costa had not projected in this 92-93 allocation of $656,618
monthly for its county share of the attendant costs was the phenomenal savings
during each calendar month of this fiscal year that this program is implemented.
If, using the state's conservative estimate that 70% of a county's IHSS caseload
would be eligible, halving the County's obligation would save $229,817 in County
dollars monthly, a total of $689,451 for the three month period. And this figure
is only for the attendant costs --it does not include the savings in staff salaries.
Totalled should easily approximate the $ 800,000 projected to be saved through
staff cuts!
You as a Board have heard a lot of concerns with regard to this program--
distrust of the state, lack of program specifics and program cost projections that
range incredibly from a loss of $914,000 to a gain of $639,000!
Board of Supervisors
Jan. 12, 1993 page two
Perhaps it is time for this Board to talk to its counterparts in surrounding
counties where you would learn:
-Not only are they prepared for Personal Care Option implementation on
April 1 but several of them are gearing up for early implementation on
February 1. They are planning to maximize federal dollars, not give up
this unprecedented opportunity.
-As of last Friday, draft regulations, not only for the California Dept. of
Social Services, but for the Department of Health were made available.
All other counties are viewing this program as an opportunity for revenue
enhancement, not as another trick up the state's sleeve:
1. While other counties are hiring social workers in anticipation of start up,
we are laying off!
2. What is going on in this County that we are so far from seizing the day
that we are moving in a direction away from preparation for this
program?
The IHSS caseloads after the projected layoff of five IHSS staff will stand
at over 300; before this addition of 84 cases to the caseload of each of the few
remaining staff, the caseloads in Contra Costa County were higher than any other
Bay Area County. In the past four months, the number of disabled and frail
elderly who have not been seen by a social worker in the past year has grown
astronomically. And yet.in order for a case to be certified as eligible to receive
Personal Care Option money, the client must have had a personal assessment by
the social worker in the past year. Does anyone think that the addition of 84
cases to an already laughable caseload will facilitate this assessment occurring?
It can't, when clearly the first priority is to grant the cases of persons who are
applying for services.
So while other counties are gearing up, our gears are completely broken.
And this Board which has evidenced such concern for the plight of services in the
face of cutbacks needs to know that the current program direction assures two
things:
- Services will not be provided.
- We will not receive federal funding to which we would otherwise be
eligible.
And these services to which I allude are in both Children and Adult
Services, since the restoration of the 50o County share should allow all thirty
positions to remain funded!
Board of Supervisors
Jan. 12, 1993 page three
This Board has stated that its first priority for Social Service Programs is
protection - protection for children, protection for those adults unable to care for
themselves. But in order to protect the children and the adults, you must first
protect the program.
Further, it is time for this Board to acknowledge that the recession that is
affecting our cities and our County should not and cannot be solved on the backs
of the social workers and their clients. The responsibility for the funding of our
General Assistance program needs to be upon every department and individual in
our County. To ask the Social Service staff and clients to solve society's problem
is counterproductive-- during time of stress and turmoil such as these we should
be providing greater services not less.
I ask that you act to reverse your original decision today. We all ask that
of you.
Sincerely yours,
KATHLEEN J. DOROSZ
Social Work Supervisor I
KD:mrs
DATE: I Z1
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(THREE (3) MINUTE LIMIT)
Complete this form and place it in the box near the speakers' rostrum before
addressing the Board.
NAME: -0)A et;A24PHONE: Si o-
ADDRESS: �,� . 5� �-'3 CITY: P.77 -�", c
I am speaking formyself OR organization: U s
(NAME OF ORGANIZATION)
Check one:
I wish to speak on Agenda Item #
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l SI
BOARD OF SUPERVISORS: 1-12-93
I AM HERE, AS A MEMBER OF THE CALIFORNIA COALITION OF INDEPENDENT
LIVING CENTERS TO REQUEST THE RESTORATION OF THE FUNDING CUT FROM
IN-HOME SUPPORT SERVICES. THE AMERICANS WITH DISABILITIES ACT
SERVED AS A TRIGGER TO ALLOW THE DISBURSEMENT OF TITLE 19 PERSONAL
CARE OPTION FUNDS FOR THE DISABLED AND FRAIL ELDERLY COMMUNITIES.
WE ARE SEEKING YOUR HELP IN EXPEDITING THE IMPLEMENTATION OF
FEDERAL TITLE 19 FUNDS WHICH WILL RESTORE THE 12% FUNDING CUT FROM
IN HOME SUPPORT SERVICES TO THE ELDERLY AND DISABLED COMMUNITIES.
LAST YEAR'S BUDGET TRAILER BILL, 1773, BY ASSEMBLEMEN
MOORE, PROVIDES THAT THE 12% CUTS BE RESTORED "AS SOON AS THE
DEPARTMENT OF FINANCE CERTIFIES THAT THE 70 MILLION DOLLAR
SHORTFALL WILL BE RESTORED BY THE PERSONAL CARE OPTION FUNDS NOW
AVAILABLE THROUGH TITLE 19" . AS OF THIS DATE, CALIFORNIA HAS BEEN
VERBALLY APPROVED TO RECEIVE THESE FUNDS. WRITTEN NOTIFICATION IS
EXPECTED ANY DAY.
WE ARE REQUESTING THAT THE BOARD OF SUPERVISORS AS WELL AS THE
DIRECTOR OF SOCIAL SERVICES AND THE DIRECTOR OF IN-HOME SUPPORT
SERVICES FOR CONTRA COSTA COUNTY, FAST-TRACT THE
APPROPRIATION OF THESE AVAILABLE FEDERAL FUNDS THROUGH THE STATE.
NOT ONLY WILL TITLE 19 FUNDS RESTORE THE IHSS CUTS, BUT WILL ADD
POSITIONS TO DECREASE THE CASE LOAD THE COUNTY WORKERS ARE NOW
FACING. IT WILL ALSO ALLOW THE EDLERLY AND DISABLED TO REMAIN IN
THEIR OWN HOMES SAFELY AND AVOID PLACEMENT IN INSITUTIONS.
i
{�►d ?fie
RECEIVED
JAN I I I�^3
CLERK BOARD OF SUPERVISORS
PROPOSED RESOLUTION I CONTRA COSTA CO.
Re : Attendant Services for People With Disabilities and
Alternatives to Institutionalization
WHEREAS, the Contra Costa Board of Supervisors and most
major advocacy groups representing older and disabled
Americans has recommended that individuals and their
families should have self-directed community based
attendant service options and alternatives to
institutional and nursing home services .
WHEREAS, the number of older and /or disabled Americans
who want and need these self-directed, community-based,
non-medical attendant services is growing every year,
WHEREAS, historical and current funding patterns of our
State and Federal governments have put substantially more
dollars into institutional and nursing home services than
into self-directed community-based attendant services
alternatives,
THEREFORE, BE IT RESOLVED, that Contra Costa County will
adopt policies and programs that will promote the :
- redirection of current Federal and State institutional
and nursing home dollars to self-directed
community-based attendant service alternatives ,
- allocation of all new Federal and State dollars in a
way that lowers the ratio between institutional and
nursing home program dollars and self-directed,
community-based attendant services options,
- removal of all regulations , funding incentives and
legislative initiatives that promote an environment
which encourages institutional and nursing home
programs over self-directed community-based
attendant service alternatives ,
- to establish the Individual Provider mode (IP) as the
primary In-Home support model,
- work with other County and State agencies to provide
case management services under the IP mode. It would
serve our communities of seniors/disabled better, to
house case management in other agencies,
�11dgq� J�G`U,�l�nq lYc�ji -more-
Page, 2-3
- work to end "local option" in IHSS and return to a
state-run program. It is evident that, "Local Option,"
generates greater problems resulting in time consuming
litigation and costly mistakes due to inconsistencies
of interpretation and management. Transportation and
voting are primary examples of this.
- establishment of a permanent advisory commission to
the Board of Supervisors during the planning,
development, implementation and operation phases of
a, "Managed Care Program," and to advise on the
Title XIX monies when they become available to the
State of California, thereby to Contra Costa County,
acting as a review panel for grievances to be heard,
(as an option to a recipient) , prior to a request for
a State of California Hearing and to act as
advisors to the Board of Supervisors, County
personnel and to be comprised of, three recipients,
(2 Medi-Cal recipients, 1 Contra Costa Health Plan
recipient, non-Medi-Cal) , one agency to represent
the senior population, one agency to represent the
disabled and three recipients, ( 1 Medi-Cal; 1 IHSS
recipient, 1 SSI/AFDC recipient) , 1 public interest
attorney representative, 1 Social Worker from each
Dept . of Social Services (no Supervisors or
Mangement) ; the Director of Health Services, the
Director Social Services or their single appointed
representative.
BE IT FURTHER RESOLVED, that Contra Costa County will work
with local advocacy groups for the implementation of new
Federal policies that will change our long term care system
from one that promotes the institutional and nursing home
model to one that provides incentives for the development of
self-directed, community-based attendant services.
BE IT FURTHER RESOLVED, that .Contra Costa County will make
this position known to the current Secretary of Health and
Human Services, Louis Sullivan and the newly appointed and
confirmed, In-coming Secretary; Pete Wilson, Governor of
California; the California State Legislature and the
American Health Care Association among others.
-30-
Respectfully submitted by:
C. C. Central Committee's, Democrats With Disabilities Club,
A quorum vote:
Executive Board, Co-Chairs, Richard Stickney, Maggie
-more-
Page 3-3
Dowling; Secretary/Treasure, Tamarah Lucio; Members: Evers,
Hoffart, Fowble, Scott, Ludwig, Gilmore, Guy, Peterson, C.
Huff, J. Huff, Pejovich, Spenser
Revision: Page 2 and add, page 3, January 9, 1993
RESOLUTION NUMBER
BOARD OF SUPERVISORS, COUNTY OF ,
STATE OF CALIFORNIA
RESOLUTION REQUESTING RESTORATION OF 12% REDUCTIONS
TO THE IHSS PROGRAM AND FOR NEW STATE FUNDS TO
IMPROVE THE PROGRAM AND IMPLEMENT PROVISIONS OF
S.B. 485 (Chapter 722, Statutes of 1992) .
RESOLVED, by the. Board of Supervisors of the County of
, State of California, that
WHEREAS, in the State Budget Act for Fiscal Year 1992-93 and
as authorized in a "budget trailer bill, " the hours of. service
provided to consumers through the In-Home Supportive Services(IHSS)
program was reduced by 12% effective October 1, 1992; and
WHEREAS, many recipients of IHSS receive SSI/SSP cash
benefits, which were reduced as a result of action taken in the
annual budget; and
WHEREAS, the older persons and those with disabilities who are
"at risk" of out-of home and institutional placements took
reductions which endanger their independence and ability to live in
their communities; and
WHEREAS, the State of California through its Health and
Welfare Agency has received written notification of approval of its
Medicaid State Plan Amendment No. 92-11, which will bring in
significant new federal funding under this "Personal Care Option; "
and
WHEREAS, the Governor and Legislature approved provisions in
S.B. 485 ( 1992) which authorizes a county to establish a "public
authority" or consortium of nonprofit corporations to administer a
"registry" which will result in improved conditions and
effectiveness of the IHSS program by utilizing support models which
build on the Individual Provider (IP) mode of delivery without
trading off cuts in hours to consumers and workers:
Page 2
NOW, THEREFORE, IT IS HEREBY DETERMINED AND ORDER THAT this
Board of Supervisors requests the Health and Welfare Agency of the
State of California to take all necessary steps to ensure that the
12% reductions in IHSS may be restored forthwith for all recipients
receiving such reductions and that no further cuts be made in the
IHSS program during this or subsequent fiscal years, and
BE IT FURTHER RESOLVED THAT this Board of Supervisors directs
its department responsible for the IHSS program to submit a plan to
the Department of Social Services (DSS) which reflects -the county's
(1) intent to restore such reductions, (2) plan and timetable to
comply with all requirements under the Medicaid Personal Care
Option and (3) planning process to create a "public authority" or
contract with a nonprofit consortium as authorized by Chapter 722,
Statues of 1992.
. � S1
i.
IHSS COALITION
"Keep What Works, Fix What's Wrong, and Fund It"
December 7, 1992
TO THE MEMBERS OF THE BOARD OF SUPERVISORS:
At the state and the county level, In-Home Supportive Services (IHSS) consumers,
workers, family members, and community supporters have formed the IHSS
Coalition.
We are writing to ask for your help. The recent state budget cuts to seniors-and
people with disabilities have had a devastating impact on our community. Many
people had their IHSS hours—which were already pegged to a minimum basic
standard--cut 12%,their SSVSSP cut 5.8%,and lost their health insurance by losing
categorical Medi-Cal status due to the SSI reduction.
One thing can be done right away. California has been verbally approved for new
federal funds--from the Title XIX Personal Care Option.-for IHSS. Written
notification is expected any day.
Last year's budget trailer bill, AB 1773 (Moore), provides that the 12*IHSS cut
must be restored AS SOON AS the Department of Finance certifies that the current
year shortfall of $70 million will be made up by bringing in at least that much in
Personal Care Option funds for this year.
_ IF THE COUNTIES AND THE STATE FAST-TRACK IMPI MENTATION OF
THE PERSONAL CARE OPTION, WE ARE CERTAIN THAT THE 12% CUT
CAN BE RESTORED RIGHT AWAY. WE ASI: YOUR ASSISTANCE IN
MAKING THAT HAPPEN.
We also need your help in planning for the future of the county's IHSS program.
In January, the state will ask the county to submit a Mid year IHSS Plan Update.
The county plan will detail how, and how much money it will cost, to implement the
Personal Care Option for IHSS locally. -
• `'..
The IHSS Coalition is asking the state legislature to budget the Personal Care Option
funds in 1993-94 to fully fund IHSS caseload so that this year's 12% cut is not
repeated. We are also asking that counties receive enough funds to create a registry
system,through either a public authority or nonprofit consortium,to screen workers,
do referrals, and coordinate training for consumers and workers.
It is essential that our county's plan request the full funding we need to make best
use of this "once in a lifetime" opportunity to qualitatively improve IHSS and the
quality of life for so many in our community.
To make IHSS work right for consumers and their families, several changes are
necessary: higher wages and benefits to recruit and retain qualified workers; a
registry system to match clients and workers; training for consumers and workers;
and taking the fust steps to direct IHSS to comply with the Americans with
Disabilities Act.
just as important is protecting the valuable aspects of IHSS, which took years of
hard work to attain: consumer independence and choice, uniform statewide
assessment, and the valuable role of family providers.
Making IHSS work right will take a lot of work. We ask you to join with us to
improve IHSS. Representatives of the coalition will be calling soon. Thank you for
your attention, consideration, and support.
For your information, we are enclosing a copy of the IHSS Coalition 1993 State
Legislative and Budget Program.
AAn d
t - RECEIVED
• JAN 111� 3
CLERK BOARD OF SUPERVISORS
PROPOSED RESOLUTION I CONTRA COSTA CO.
Re : Attendant Services for People With Disabilities and
Alternatives to Institutionalization
WHEREAS, the Contra Costa Board of Supervisors and most
major advocacy groups representing older and disabled
Americans has recommended that individuals and their
families should have self-directed community based
attendant service options and alternatives to
institutional and nursing home services .
WHEREAS, the number of older and /or disabled Americans
who want and need these self-directed, community-based,
non-medical attendant services is growing every year,
WHEREAS, historical and current funding patterns of our
State and Federal governments have put substantially more
dollars into institutional and nursing home services than
into self-directed community-based attendant services
alternatives,
THEREFORE, BE IT RESOLVED, that Contra Costa County will
adopt policies and programs that will promote the : .
- redirection of current Federal and State institutional
and nursing home dollars to self-directed
community-based attendant service alternatives,
- allocation of all new Federal and State dollars in a
way that lowers the ratio between institutional and
nursing home program dollars and self-directed,
community-based attendant services options,
- removal of all regulations, funding incentives and
legislative initiatives that promote an environment
which encourages institutional and nursing home
programs over self-directed community-based
attendant service alternatives,
to establish the Individual Provider mode (IP) as the
primary In-Home support model,
- work with other County and State agencies to provide
case management services under. the IP mode. It would
serve our communities of seniors/disabled better, to
house case management in other agencies,
��� •����� -more-
e
Page, 2-3
work to end "local option" in IHSS and return to a
state-run program. It is evident that, "Local Option,"
generates greater problems resulting in time consuming
litigation and costly mistakes due to inconsistencies
of interpretation and management. Transportation and
voting are primary examples of this.
establishment of a permanent advisory commission to
the Board of Supervisors during the planning,
development, implementation and operation phases of
a, "Managed Care Program," and to advise on the
Title XIX monies when they become available to the
State of California, thereby to Contra Costa County,
acting as a review panel for grievances to be heard,
(as an option to a recipient) , prior to a request for
a State of California Hearing and to act as
advisors to the Board of Supervisors, County
personnel and to be comprised of, three recipients,
(2 Medi-Cal recipients, 1 Contra Costa Health Plan
recipient, non-Medi-Cal) , one agency to represent
the senior population, one agency to represent the
disabled and three recipients, (1 Medi-Cal; 1 IHSS
recipient, 1 SSI/AFDC recipient) , 1 public interest
attorney representative, 1 Social Worker from each
Dept. of Social Services (no Supervisors or
Mangement) ; the Director of Health Services, the
Director Social Services or their single appointed
representative.
BE IT FURTHER RESOLVED, that Contra Costa County will work
with local advocacy groups for the implementation of new
Federal policies that will change our long term care system
from one that promotes the institutional and nursing home
model to one that provides incentives for the development of
self-directed, community-based attendant services.
BE IT FURTHER RESOLVED, that Contra Costa County will make
this position known to the current Secretary of Health and
Human Services, Louis Sullivan and the newly appointed and
confirmed, In-coming Secretary; Pete Wilson, Governor of
California; the California State Legislature and the
American Health Care Association among others.
-30-
Respectfully submitted by:
C. C. Central Committee's, Democrats With Disabilities Club,
A quorum vote:
Executive Board, Co-Chairs, Richard Stickney, Maggie
-more-
.ti
Page 3-3
Dowling; Secretary/Treasure, Tamarah Lucio; Members: Evers,
Hoffart, Fowble, Scott, Ludwig, Gilmore, Guy, Peterson, C.
Huff, J. Huff, Pejovich, Spenser
Revision: Page 2 and add, page 3, January 9, 1993
DATE: cl
REQUEST TO SPEAK FORM
(THREE (3) MINUTE LIMIT
Complete this form and place it in the box near the speakers' rostrum before
addressing the Board.
NAME: J 64 Y\-Yl e- Bc-:E� PHONE:
ADDRESS: 96'-3-7 e l ef"SQ' lnr lCITY: Pl ea s o vx+
I am speaking formyself OR organization: � o e l.._i vk Luc,
Chec 'one:
(NAM OF ORGANIZATION)
Ch7ec
J
I wish to speak on Agenda Item # I. 5
My comments will be: general for against
I wish to s eak on the sub ect of Fed-q�,
P J ���E�r��ds-��S�sS
I do not wish to speak but leave these comments for the Board to consider.