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CONTRA COSTA COUNT' -11OME SUPPORTIVE SERVICES PUBLIC AUTHORITY IMPLEMENTATION TEAM ,FINDINGS & RECOMMENDATIONS �P.resen#ed to: Joh n Cullen, Drecter 'So ial Service Departrr Marcli 1999 TABLE OF CONTENTS Public Authority Implementation Team .................................................................. iii Summary of Recommendations .................. ......................................................... v CHAPTER ONE: INTRODUCTION Background ........................................................................ I Implementation Team Recruitment ............................................ I Implementation Team Member Appointment ................................. I Implementation Team Group Process .......................................... 2 Organization of this Report ..................................................... 2 CHAPTER TWO: FINDINGS AND RECOMMENDATIONS: Public Authority Role, Responsibilities, Relationship and Level of Coordination with Other Entities Introduction ... ................................................... ................ 3 Roles and Responsibilities of Public Authority Staff ..........................3 Division of Responsibilities and Coordination Between County IHSS and Public Authority Staff ....................................... 4 Division of Responsibilities Between Public Authority Staff and County Special Needs Desk ............................ ....... ...... 5 Coordination Between County IHSS and Public AuthorityStaff .................................................................... 6 Roles, Responsibilities and Relationships of Other County Entities .............................................................. 7 CHAPTER THREE: FINDINGS AND RECOMMENDATIONS: Public Authority Values, Mission Statement and Duties Introduction ................................... ..................................... I I Public Authority Values Statement .............................................. I I Public Authority Mission Statement ........................................ .... 12 Public Authority Statement of Duties ............................................ 12 CHAPTER FOUR: FINDINGS AND RECOMMENDATIONS: Public Authority Advisory Committee Role, Mission, Duties and Membership Introduction ......................................................................... 13 Advisory Committee Role ........................................................ 13 Advisory Committee Mission Statement ...................................... 13 Advisory Committee Statement of Duties ....................................... 13 Advisory Committee Membership ............................................... 14 CHAPTER FIVE: FINDINGS AND RECOMMENDATIONS: Public Authority Registry Design, Operations and Policies and Procedures Introduction ......................................................................... 17 RegistryDesign ........... .......................................................... 17 Registry Operations and Policies and Procedures ............................. 18 i CHAPTER SIX: FINDINGS AND RECOMMENDATIONS: Consumer and Provider Support Services and Consumer and Provider Training Introduction ................................................. ....................... 37 Consumer and Provider Support Services ............................... 37 Consumer and Provider Training ............................................... 38 CHAPTER SEVEN: FINDINGS AND RECOMMENDATIONS: Executive Director Reporting Structure, Staff Positions, Job Descriptions, Salaries and Benefits.Office Space, Performance Measures, Budget and Rate, Documentation Required by the California Department of Social Services Introduction ..................... ............................ ...................... 40 Executive Director Reporting Structure ..........................................40 Staff Positions,Job Descriptions, Salaries and Benefits ................................................................43 Public Authority Office Space.................................................... 44 Performance Measures ............................................................. 45 Budgetand Rate ...................................................... ............. 46 Documentation Required by the California Department of Social Services.........................................47 APPENDICES: A. Implementation Team Meeting Ground Rules B. Implementation Team Decision-Making Process C. Implementation Team Work Plan Outline D. Implementation Team Steering Committee E. Implementation Team Meeting Schedule F. January 27, 1998 Staff Report G. County Ordinance No. 98-14 IHSS Authority H. Welfare and Institutions Code 12301.6 I. CDSS ACL No. 98-20 and Public Authority Regulations J. Reference to DOJ Study—Criminal Background Checks K. Assembly Bill 857—Criminal Background Checks L. Recommended Public Authority Staff Job Descriptions M. Sample Consumer Satisfaction Surveys N. Performance Measures Used by other Public Authorities O. Sample Provider Satisfaction Survey P. Recommended Public Authority Budget, Rate and Rate Narrative Q. Organizational Chart of Public Authority R. Public Authority Staffing, Classifications And Duties S. How Functional Requirements Will Be Met T. CDSS Rate Form U. Statement of Facts Roster of Public Agencies Filing ii ----------- PUBLIC AUTHORITY IMPLEMENTATION TEAM Represen#ing: Trudi Riley, Chair Attorneys K gey Dorosz,Vice Chair Senior Advocates Linda Anderson Social Service Department Bang Carnmer Community-Based Organization Andrea Cassidy County Counsel Dorothy Clinton Elderly Consumers Paul DeMange Younger Disabled Advocates Karen Graver Younger Disabled Consumers Synthia L. Hakola Providers Diane Hanus Providers Arthur C. Hollister, MD MPH Physicians Kathy Ito Human Resources Department Clint Jossey Social Service Department Sandra Medvedoff' Elderly Consumers Leon F. Morphew Senior Advocates Diane Flyer Polak Geriatric Specialists Jim Reeves 'Younger Disabled Consumers Maralee Reiner Disability Specialists&Providers Bob Sessler Social Service Department iii Gordon J. Shasky Younger Disabled Consumers Carol Sheridan Organized Labor, SEIU 535 Dana Simon Organized Labor, SEIU 250 Frances Smith Younger Disabled Advocates Joe Tonda Risk Management Division Judy Wallace Social Workers Joan Weber, R.N. Nurses Jeff Wilkins Community-Based Organization iv SUMMARY OF RECOMMENDATIONS Recommendation 1: Adopt proposed recommendation on Public Authority (page 3) staff rotes and responsibilities. Recommendation 2: Adopt proposed recommendation on division of responsibilities (page 4) between County IHSS and Public Authority staff. Recommendation 3: 3-1: Adopt proposed recommendation on division of (page 5) responsibilities between the Public Authority and Special Deeds Desk. (page 6) 3-2: Adopt proposed recommendation on protocols for referrals between Public Authority and Special Needs Desk. (page 6) 3-3: Adopt proposed recommendation on annual review of relationship between Public Authority and Special Needs Desk. Recommendation 4: Adopt proposed recommendation on plan for ongoing (page 6) coordination between County IHSS and Public Authority staff. Recommendation 5: 5-1: Adopt proposed recommendation on Board of (page 7) Supervisors roles and responsibilities. (page 8) 5-2: Adopt proposed recommendation}on Office of County Administrator roles and responsibilities. (page S) 5-3: Adopt proposed recommendation on Social Service Department roles and responsibilities. (page 9) 5-4: Adopt proposed recommendation on County Counsel roles and responsibilities. (Inge 9) 5-5: Adopt proposed recommendation on Human Resources Department roles and responsibilities. (page 9) 5-6: Adopt proposed recommendation on Risk Management Department roles and responsibilities. (page 10) 5-7: Adopt proposed recommendation on Auditor/Controller's Office roles and responsibilities. Recommendation 6: 6-1: Adopt proposed recommendation on Public Authority (page 11) Values Statement. v (page 12) 6-2: Adopt proposed recommendation on Public Authority Mission Statement. (page 12) 6-3: Adopt proposed recommendation on Public Authority Statement of Duties. Recommendation 7: 7-1: Adopt proposed recommendation on the primary role (page 13) of the Advisory Committee. (page 13) 7-2: Adopt proposed recommendation on Advisory Committee Mission Statement. (page 13) 7-3: Adopt proposed recommendation on Advisory Committee Statement of Duties. (page 14) 7-4: Adopt proposed recommendations on Advisory Committee Membership. Recommendation 8: 8-1: Adopt proposed recommendation on Registry being (page 17) centralized and operated by the Public Authority. (page 17) 8-2: Adopt proposed recommendation on the Registry providing off-site stations. (page 17) 8-3: Adopt proposed recommendation that the Registry serve only IHSS consumers and providers. (page 18) 8-4: Adopt proposed recommendation that the Registry use registry software and forms previously developed by the County. Recommendation 9: 9-1: Adopt proposed recommendation on Provider (page 19) Recruitment Policy and Procedure. (page 20) 9-2: Adopt proposed recommendation on Provider Application and Intake Policy and Procedure. (page 22) 9-3: Adopt proposed recommendation on Provider Employment Eligibility Policy and Procedure. (page 22) 9-4: Adopt proposed recommendation on Provider References Policy and Procedure. (page 23) 9-5: Adopt proposed recommendation on Provider Interview/Orientation Policy and Procedure. V1 (page 24) 9-6: Adopt proposed recommendation on provider health screening. (page 25) 9-7: Adopt proposed recommendation on Provider Follow-up Policy and Procedure. (page 26) 9-8: Adapt proposed recommendation on Provider Removal from Registry Policy and Procedure. (page 28) 9-9: Adopt proposed recommendation on Referral of Consumers to the Registry Policy and Procedure. (page 29) 9-10: Adopt proposed recommendation on Consumer Intake Policy and Procedure. (page 30) 9-11: Adopt proposed recommendation on Generating List of Providers Policy and Procedure. (page 32) 9-12: Adopt proposed recommendation on Referral of Providers to Consumer Policy and Procedure. (page 33) 9-13: Adopt proposed recommendation on addressing urgent and emergency needs. (page 34) 9.14: Adopt proposed recommendation on Consumer Follow- up Policy and Procedure. (page 36) 9-15: Adopt proposed recommendation on potential exclusion of consumers from Registry services. Recommendation 10: Adopt proposed recommendation on consumer and (page 37) provider support services. Recommendation 11: Adopt proposed recommendation on Consumer and (page 38) Provider Training Policy and Procedure. Recommendation 12: 12-1: Adopt proposed recommendation on Public (page 43) Authority staff positions. (page 44) 12-2: Adopt proposed recommendation on Public Authority staff job descriptions. (page 44) 12-3: Adopt proposed recommendation on Public Authority staff salary ranges and benefits. vii Recommendation 13: Adopt proposed recommendations on Public Authority (page 44) office space. Recommendation 14: 14-1: Adopt proposed recommendations on Public Authority (page 45) performance measures. Recommendation 14: 14-2: Adopt proposed recommendation on provider (page 46) satisfaction performance measure(s) and satisfaction survey. Recommendation 15: Adopt proposed recommendation on Public Authority (page 47) budget and rate. viii CHAPTER ONE INTRODUCTION Background On July 1, 1998 the Contra Costa County Social Service Department retained the services of Eldon E. Luce Consulting to assist the County in establishing the Contra Costa County In- Horne Supportive Services (IHSS) Public Authority. The role of the consultant, under the supervision of the Director of the Social Service Department or his designee, was to facilitate the work of an Ad-Hoc Implementation Team to establish the Contra Costa County IHSS Public Authority. The goal of the Public Authority Implementation Team was to bring to the Director of the Social Service Department a recommended design and implementation plan for the Public Authority. Implementation Team Member Recruitment The goal of recruitment was to achieve Team membership that represented a cross-section of key stakeholders and constituencies relative to the IHSS program. Representative categories of membership included elderly consumers, younger disabled consumers, providers, organized labor, senior advocates, younger disabled advocates, attorneys, physicians, nurses, social workers, geriatric specialists, disability specialists, community-based organizations and County departments. In consultation with the Social Service Department and community members, it was determined that twenty (20) community members and five (5) County representatives would achieve the desired representation. Distribution of applications for membership on the Implementation Team began on July 23, 1998. Notification of the recruitment process Megan running in the local media on July 29, 1998. Applications were widely distributed through mailings, dissemination by the IHSS Task Force and via individual requests. Recruitment efforts resulted in the County receiving forty-seven(47)applications for Implementation Team membership. Implementation Team Member Appointment With approval from the Social Service Department Director, an Application Review Panel was constituted. Members of this panel included a representative from the Social Service Department, a representative from the Independent Living Resource Center and the consultant. The role of the Review Panel was to review all applications and make membership recommendations to the Social Service Department Director. All of the applications and the Review Panel recommendations were forwarded to the Department Director for a decision on appointments to the Implementation Team. The final appointments included a membership that represented a fair cross section of stakeholders and provided a strong, productive work group. t Implementation Team Group Process During the first Implementation Team meeting(September 3, 1998)the membership: ■ Agreed on meeting ground rules and the group decision-making process;2 ■ Agreed on a comprehensive work plan for designing the Public Authority;3 ■ Decided on the role and membership of a steering committee;4 and ■ Developed a schedule of future meetings.5 The majority of the recommendations contained in this report are the product of consensus among members of the Implementation Team. We are proud of the fact that we have been able to reach common ground on most matters;this is a tribute to the flexibility and good will of the Implementation Team's membership. Of course, opinions do vary on some matters. To address the possibility of a significant difference of opinion, the members agreed that inclusion of a minority opinion would be an option. The members agreed that a minority opinion might be appropriate if there was a "significant minority" that had a differing opinion from the majority. The members further agreed that if there was a minority opinion on a particular issue/recommendation, it would be included directly following the majority opinion/reconinendation in the final report. This occurs once in the following report. Organization of this Report This report is organized into six general areas: (1) Public Authority Role, Responsibilities, Relationship and Level of Coordination with Other Entities; (2) Public Authority Values, Mission Statement and Duties; (3) Public Authority Advisory Committee Role, Mission, Duties and Membership; (4) Public Authority Registry Design, Operations, and Policies and Procedures; (5) Consumer and Provider Support Services and Consumer and Provider Training; and (6) Public Authority Executive Director Reporting Structure, Staff Positions, Job Descriptions, Salaries and Benefits, Performance Measures, Office Space, Budget, .Rate and Documentation Required by the California Department Of Social Services. Chapters two through seven outline the Implementation Team's report and recommendations in each of these areas. The Implementation Team is pleased to have had the opportunity to provide recommendations on the design for the Contra Costa IHSS Public Authority. The recommendations included in this report are a product of the diversity of knowledge represented by Implementation Team members, technical assistance from other public authorities and input gathered from three community forums. I APPENDIX A-Implementation Team Meeting Ground Rules APPENDIX B-Implementation Team Decision-Making Process S APPENDIX C-Implementation Team Comprehensive work Plan Outline a APPENDIX D-Implementation Team Steering Committee s APPENDIX E-Implementation Team Meeting Schedule 2 CHAPTER TWO FINDINGS AND RECOMMENDATIONS Public Authority hole,Responsibilities, Relationship and Level of Coordination with Other Entities Introduction This section of the Implementation Team's report presents findings and recommendations regarding the roles and responsibilities of Public Authority staff; the division of responsibilities and coordination between County IHSS and Public Authority staff; and the roles, responsibilities and relationships of other County entities relative to the Public Authority. In developing the recommendations included in this section, Team members considered information included in the January 27, 1998 staff report,6 County Ordinance No. 98-14 In-Home Supportive Services Authority,7 Public Authority statutes, California Department of Social Services (CRSS) All County Letter (ACI ) NO. 98-20 and Public Authority Regulations9 and practices of operating public authorities. Roles and Responsibilities of Public Authority Staff The Implementation Team agrees that it is essential to dune, and have agreement on, the roles and responsibilities of Public Authority staff prior to implementation of Public Authority operations. Recommendation 1: Adopt proposed recommendation on Public Authority staff roles and responsibilities. The Implementation Team recommends that Public Authority staff roles and responsibilities include: a The Public Authority Executive Director serving as principle staff to the Advisory Committee a The Public Authority Executive Director acting as liaison. to Board of Supervisors, County Administrator and County Departments and representing the Public Authority at the local and state level regarding Public Authority issues W Conducting all Public Authority activities in accordance with Board established policy 6 APPENDIX F-January 27, 1998 staff report APPENDIX o-County ordinance No.9814 8 APPENDIX H-W&I Code 12301.6 9 APPENDIX I-CDSS ACL,NO.98-20 and Public Authority Regulations 3 • Obtaining all required Board approvals before taking action • With Governing Board approval, engaging in advocacy activities related to IHSS consumer and provider issues • Providing input into collective bargaining process • Implementing Board policy relative to employer of record responsibilities ■ Coordinating activities with County IHSS i Consulting with Social Service Department, County Counsel, Human Resources and Risk Management as outlined in recommendations 5-3, 5-4, 5-5, and 5-6, including but not limited to, the development and operation of Public Authority service functions, i.e., registry, provider screening, referral system, consumer and provider training, and other Board approved functions ■ Acting in accordance with requirements outlined in Interagency Agreement between Public Authority and Social Service Department ■ Making decisions and hearing appeals regarding removal of providers from the Registry ■ Providing all required information and reports it Complying with all relevant County, State and Federal laws,regulations and agreements Division of Responsibilities and Coordination Between County IHSS and Public Authority Staff The Implementation Team recognizes the need for Public Authority staff to closely coordinate activities and services with those of the County IHSS program. It is with County IHSS that the Public Authority will have the closest programmatic connection, since both programs will be serving the same consumer population. Considering the importance of this relationship, the Team believes it is critical to define both the division of responsibilities and level of coordination between these two programs. The following recommendations were developed based on the understanding that the Public Authority will be primarily involved in the provider components of IHSS and County IHSS will be primarily involved in the consumer components of IHSS. Recommendation 2: Adopt proposed recommendation on division of responsibilities Between County IHSS and Public Authority staff; The Implementation Team recommends the following division of responsibilities between County IHSS and Public Authority staff 4 County IHSS-- Public Authority Staff Determines consumer eligibility Provides consumer input into IHSS Performs initial consumer assessments Provides: Registry Performs consumer re-assessments Provider screening Referral system Authorizes consumer tasks/hours Training and support services Enrolls Individual Providers (1P) for consumers and providers Performs IP payroll functions Implements Board policy relative to employer of record responsibilities Performs case management functions (e.g. social casework,personal counseling; referral to community resources) Division of Responsibilities Between Public Authority Staff and County Special Needs Desk The Implementation Team recognizes the need for Public Authority staff to closely coordinate activities and services with those of the Special Needs Desk. This is critical due to the fact that both programs will not only be serving the same consumer population, but will be providing very similar types of supportive services. Taking this into consideration, the Team believes it important to define the division of responsibilities between the two programs. In addressing this issue, the Team again relied on the general division of responsibilities: the Public Authority being primarily involved in the provider components of IHSS and the Special Needs Desk being primarily involved in the consumer components of IHSS. Recommendation 3: 3-1: Adopt proposed recommendation on division of responsibilities between the Public Authority and Special Needs Desk. The Implementation Team recommends the following division of responsibilities between the Public Authority and Special Needs Desk: Public Authority Staff Special Needs Desk(SNDA Operates the Registry Staff obtains lists of providers from the Registry for SND consumers Provides supportive services if need Provides supportive services if the for services is directly related to services are needed as a result of issues consumer/provider issues,e.g., requiring IHSS casework hiring, firing and supervision of provider,training 5 3-2: Adapt proposed recommendation on protocols for referrals between. Public Authority and Special.Needs Desk. The Implementation Team recommends that Public Authority staff, Advisory Committee and Special Deeds Desk staff develop protocols for how, when and which consumers are referred to Public Authority and how, when and which consumers are referred to the Special Needs Desk. 3-3: Adapt proposed recommendation on annual review of relationship between Public Authority and Special Needs Desk. The Implementation Team recommends that there be an annual review of the relationship between the Public Authority and the Special Needs Desk, including consideration of fiscal and funding issues. Coordination Between County IHSS and Public Authority Staff The previous recommendations recognized the importance of establishing a division of responsibilities between County IHSS and Public Authority staff. The following recommendation recognizes the need for, and value of, ongoing coordination of the activities and services of County IHSS and the Public Authority. Recommendation 4: Adopt proposed recommendation on plan for ongoing coordination between County IHSS and Public Authority staff. The Implementation Team recommends the following plan for ongoing coordination between County IHSS and Public Authority staff: County IHSS Public Authority Staff Provides input into PA policy,procedures and performance indicators Provides input into County IHSS Inclusion in PA Advisory Committee meetings Inclusion in IHSS Program Committee meetings Distributes PA related materials Provides IHSS with feedback on consumer needs and Registry referrals Provides PA copy of 293 with referrals Provides reports to HISS on Registry outcomes, consumer/worker satisfaction and performance measures 6 Public Authority staff and IHSS staff will jointly develop Registry Intake Forms and Public Authority related materials for distribution to consumers and providers. Roles,Responsibilities and Relationships of Other County Entities While the Implementation Team recognizes the Public Authority's primary programmatic relationship will be with County IHSS; the Team further recognizes the necessity and value of developing and maintaining technical,professional and liaison relationships with a number of other County entities. The Team agrees these County entities will include the Board of Supervisors, County Administrator, Social Service Department, County Counsel, Human Resources Department, Risk Management Department and the Auditor,/Controller's Office. The following recommendations define the roles and responsibilities relative to each of these entities. Recommendation 5: 5-1: Adopt proposed recommendation on Board of Supervisors roles and responsibilities. The Implementation Team recommends the following roles and responsibilities for the Board of Supervisors, acting as the Public Authority governing body: • Establishes policy direction for Public Authority • Oversees Public Authority operations • Recruits and appoints Advisory Committee members • Seeks and considers Advisory Committee input ■ Hires and supervises, or delegates supervision of, Public Authority Executive Director • Adopts employer-employee relations policy for Public Authority • Conducts or arranges for labor representation election • Establishes policy direction relative to collective-bargaining activities • Approves the Public Authority budget • Approves Public Authority reimbursement rate to be submitted to the State by the Social Service Department • Approves Interagency Agreement between Public Authority and Social Service Department 7 5-2: Adopt proposed recommendation on Office of the County Administrator rotes and responsibilities. The Implementation Team recommends the following rales and responsibilities for the Office of the County Administrator: • Facilitates communication between Public Authority staff and Advisory Committee and the Board of Supervisors/Public Authority governing body ■ Schedules Public Authority items for Board agenda ■ Specific services and costs of services provided by the Office of the County Administrator may be included in the Interagency Agreement between Social Service Department and the Public Authority 5-3: Adopt proposed recommendation on Social Service Department roles and responsibilities. The Implementation Team recommends the following roles and responsibilities for the Social Service Department: • Consults with Public Authority staff: a) to develop Public Authority budget, materials required by the State, Public Authority reimbursement rate, and Interagency Agreement b) regarding Public Authority staff and/or Advisory Committee educational and informational activities c) regarding proposed contracts d) regarding development and operations of Registry,provider screening,referral system,consumer and provider training and support services, and other Board- approved functions • Enters into and monitors Interagency Agreement; and assures provision of services agreed to in Interagency Agreement ■ Monitors Public Authority budget ■ Submits materials required by the State, including Public Authority rate approval application and documentation and fiscal claims ■ Specific services and costs of services provided by the Social Service (Department will be included in the Interagency Agreement between Social Service Department and the Public Authority 8 5-4: Adopt proposed recommendation on County Counsel roles and responsibilities. The Implementation Team recommends the following roles and responsibilities for County Counsel: • Provides legal consultation, e.g., review and approval of Board memos and resolutions, contracts • Provides representation services • Consults with Public Authority staff regarding developmentand operations of Registry, provider screening, referral system, consumer and provider training and support services, and other Board-approved functions • Specific services and costs of services provided by County Counsel will be included in the Interagency Agreement between Social Service Department and the Public Authority 5-5: Adopt proposed recommendation on Duman Resources Department roles and responsibilities. The Implementation Team recommends the following roles and responsibilities for the Human Resources Department: • Assists the Public Authority with: employee recruitment, classification, salary structure and employment issues, employee benefits and benefits management and development of Public Authority Personnel Rules • Manages/administers labor relations activities for the Public Authority ■ Consults with Governing Board, Public Authority staff and Advisory Committee on Public Authority labor relations and collective bargaining activities • Specific services and costs of services provided by the Human Resources .Department will be included in the Interagency Agreement between Social Service Department and the Public Authority 5-6: Adopt proposed recommendation on tisk Management Department roles and responsibilities. The Implementation Team recommends the following roles and responsibilities for the Risk Management Department: • Provides risk analysis of exposure to loss and consultation on Public Authority insurance coverage 9 Arranges for necessary Public Authority insurance coverage ■ Consultation and approval, in concert with County Counsel, of insurance and indemnification requirements on contracts • Specific services and costs of services provided by the Risk Management Department will be included in the Interagency Agreement between Social Service Department and the Public Authority 5-7: Adopt proposed recommendation on Auditor/Controller's Office roles and responsibilities. The Implementation Team recommends the following rales and responsibilities for the Auditor/Controller's Office: ■ Assists with Public Authority staff payroll services ■ The payroll process is to be kept as consistent as possible with the County system ■ Specific services and costs of services provided by the Auditor/Controller's Office may be included in the Interagency Agreement between Social Service Department and the Public Authority 10 CHAPTER THREE FINDINGS AND RECOMMENDATIONS Public Authority Values,Mission Statement and Duties Introduction This section of the Implementation Team's report presents findings and recommendations regarding the Public Authority's values, mission statement and duties. In developing the recommendations included in this section, Team members considered information included in the January 27, 1998 staff report, County Ordinance No. 98-14, Public Authority statutes and regulations, community input and the values, mission and duties of operating public authorities. The Team process included thoughtful deliberations on: the values that would serve as the foundation for the organization's mission; a mission statement that incorporated the values; and the duties that would facilitate accomplishment of the organization's mission. Recommendation 6. 6-1: Adopt proposed recommendation on Public Authority Values Statement. The Implementation Team's discussion relative to Public Authority values emphasized the group's belief in the importance of. IHSS to elderly and disabled consumers; consumers making decisions/having a voice in their services and in Public Authority policy and program development; locating and maintaining a relationship with appropriate IHSS providers; IHSS providers being treated with dignity and respect; and providers needs and interests being heard and considered. The following recommendation incorporates these beliefs into a Values Statement. The Implementation Team recommends the following Public Authority Values Statement: I. Eligible elderly and disabled consumers need/deserve IHSS in order to remain as safe and independent as possible. 2. Consumer should, to the greatest extent possible within the constraints of the program, make decisions concerning the services they receive; consumers should have assistance in locating and maintaining their relationship with IHSS providers that are available, trustworthy, reliable and that meet the service needs of the consumer; and consumers need/deserve a voice in Public Authority policy and Public Authority program development. 3. IHSS providers need/deserve to be treated with the dignity and respect their important work deserves; and their needs and interests should be heard and considered. 11 6-2: Adopt proposed recommendation on Public Authority Mission Statement. In developing the Public Authority Mission Statement, the Implementation Team designed a statement that incorporates the values recommended by the group. The Implementation Team recommends the following Public Authority Mission Statement: The mission of the Public Authority is to provide consumers with access to IHSS providers who meet consumers' service needs, to provide services that support a positive and productive relationship between the consumer and provider, to give consumers a voice in Public Authority policy and program development and to serve as the employer of record for IHSS Independent Providers. 6-3: Adopt proposed recommendation on Public Authority Statement of Duties. In developing duties for the Public Authority the Implementation Team, carefully considered what duties would be essential in facilitating accomplishment of the organization's mission. The Implementation Team recommends the following Public Authority Statement of Duties: I. Serve as employer of record for IHSS Individual Providers for the purposes of collective bargaining over wages, benefits and terms and conditions of employment. 2. Provide consumer input into Public Authority program and policy development through Public Authority Advisory Committee. 3. Develop/manage IHSS worker registry and referral system for referral of providers to consumers. 4. Investigate qualifications and background of potential IHSS providers. 5. Provide training for providers and consumers. 6. Provide or refer to supportive services that assist in assuring a successful, productive and accountable relationship between the consumer and provider. 7. Perform other Board-approved administrative activities related to the delivery of IHSS. 12 CHAPTER.FOUR FINDINGS ANIS RECOMMENDATIONS Public Authority Advisory Committee Role, Mission, Duties and Membership Introduction This section of the Implementation Team's report presents findings and recommendations regarding the Public Authority Advisory Committee's role, mission, duties and membership. In developing the recommendations included in this section, Team members considered information included in the January 27, 1998 staff report, Public Authority statutes and regulations, County Ordinance No. 98-14, community input and the role,mission, duties and membership of operating public authority advisory committees. The Team process included thoughtful deliberations on: the role of the Advisory Committee; a mission statement that reflected the Committee's role and recognized the need for community input into Public Authority program and policy development; the duties that would facilitate accomplishment of the Committee's mission; and the membership that could most effectively carry out the Committee's mission and duties. Recommendation 7: 7-1: Adopt proposed recommendation that the primary role of the Advisory Committee be to serve in an advisory capacity to the Public Authority Governing Board and to the Public Authority staff. 7-2: Adopt proposed recommendation on Advisory Committee Mission Statement. In developing the Advisory Committee Mission Statement the Implementation Team designed a statement that incorporates the primary role of the Committee and that recognizes the value of input from consumers,providers and other interested parties. The Implementation Team recommends the following Advisory Committee Mission Statement: ■ The Mission of the Public Authority Advisory Committee is to provide advice and assistance to the Board and staff'of the Public Authority; and to provide a forum for consumers of personal assistance services, providers, advocates and other interested parties to participate in Public Authority policy and program development. 7-3: Adopt proposed recommendation on Advisory Committee Statement of Duties. In developing duties for the Advisory Committee the Implementation Team carefully considered what duties would be essential to facilitating accomplishment of the Committee's mission. 13 The Implementation Team recommends the following Advisory Committee Statement of Duties: 1. Stay informed/educated on IHSS/Public Authority issues. 2. Provide consumer input into IHSS Public Authority operations. 3. Provide input regarding Public Authority policy and program development, Public Authority activities and services, and Public Authority budget. 4. Participate in outreach and educational activities. 5. Review, advise and make recommendations to the Board, via the County Administrator's legislative staff',' on pending legislation that may impact the IHSS program,consumers,providers,and/or Public'Authorities. 6. With Governing Board approval, engage in advocacy activities related to IHSS consumer and provider issues. 7. Provide input on collective-bargaining issues. 8. Hear appeals and make final decisions regarding removal of providers from the Registry. 7-4: Adopt proposed recommendations on Advisory Committee membership. Public Authority Regulations require that the Board of Supervisors, acting as the Public Authority: 1) appoint an advisory committee of no more than eleven (11) members; and 2) no fewer than 50 percent of the advisory committee members shall be persons who are current or past users of personal assistance services paid for through public or private funds. Using the regulatory requirements and County Ordinance as a starting point, the Implementation Team addressed the membership of the Advisory Committee. The group addressed the issues of the total number of Committee members; number and characteristics of consumer representatives, including current or past users, services paid for by public funds or private pay and the appointment of consumer members based on age, disability and/or other criteria;the number and representative categories for "other" members; and the desire that membership represent the ethnic, racial, geographic, age and other diversities of the County's IHSS consumer and provider populations. After careful consideration, the majority of Team members agree that the following recommendation will give broad, fair and representative consumer and stakeholder membership on the Advisory Committee. 14 The majority of Implementation Team members recommend the following regarding Advisory Committee membership: 1. Memhersh_ip all 'nclude six{6}consumers: a) Consumer members shall be individuals who are current or past users of personal assistance services paid for through public or private funds; b) At least 50 percent of consumer members shall be current users of IHSS; c) Consumer members will represent two age categories, i.e.$ consumers over 65 years of age and consumers under 65 years of age; d) The number of members appointed from each age category will be representative of the IHSS caseload. In the current IHSS caseload 66.66 percent of consumers are over 65 years of age and 33.33 percent are under 65 years of age; e) This will result in four (4) consumer members being appointed who are over 65 years of age; and two (2) consumer members being appointed who are under 65 years of age; and f) Consumer members shall be residents of Contra Costa County. Minoritv_opinio on corp: Amer members: There was a significant minority of Team members that felt appointing three (3) consumer members over 65 years of age; and three (3) consumer members under 65 years of age would give fairer consumer representation than that reflected in the majority recommendation. 2. Membership shall include five(5) other positions: a) The five positions shall be appointed from each of the five supervisorial districts; b) Individuals appointed shall live or work in Contra Costa County; and c) Supervisors will attempt to select the members from the list of recommended categories. * d) The selection process shall be coordinated to achieve the following: no category shall have more than one representative; and one of the appointments shall be an IHSS individual provider or IHSS family provider. 15 * List of recommended Advisory Committee member categories The Implementation Team believes individuals representing the following categories will bring significant and relevant expertise to the Advisory Committee. senior advocate • advocate for younger disabled ■ representative from the developmental disability community = IHSS individual provider • IHSS family provider = social worker ■ nurse ■ community-based organization representative = home health agency representative 3. The Implementation Teamm recommends that efforts be made to recruit and select Advisory Committee members representing the ethnic, racial, geographic, age and ether diversities of the County's IHSS consumer and provider populations. = It is suggested that the application for Advisory Committee membership include a statement regarding the Board's desire that Advisory Committee membership reflect the ethnic, racial, geographic, age and other diversities of the County's IHSS consumer and provider populations; and that the application include a section where the applicant may voluntarily state his/her ethnicity. 4. To further address the issue of Advisory Committee membership, the Team recommends that the Public Authority reviews Advisory Committee membership annually to determine if the membership meets the needs of the .key stakeholder groups; and make appropriate membership adjustments, if necessary. S. The Social Service Director recommends that Advisory Committee members be appointed to jour year terms. However, six of'the initial eleven appointees should be limited by lot to only two year terms spa that membership terms are staggered. 16 CHAPTER FIVE FINDINGS AND RECOMMENDATIONS Public Authority Registry Design, Operations, and Policies and Procedures Introduction This section of the Implementation Team's report presents findings and recommendations regarding the Public Authority Registry's design and policies and procedures. In developing the recommendations included in this section, Team members considered information included in the January 27, 1998 staff report, Public Authority statutes and regulations, County Ordinance No. 98-14, community input and practices of operating public authorities. Many of the following recommendations are presented as policies and procedures. These recommended policies and procedures include all aspects of Registry operations. The Team felt that structuring the recommendations as policies and procedures would be helpful to the Public Authority as the staff`begins operation of the Registry. .Registry Design In making recommendations on the design of the Registry, the Team addressed the following questions: 1) Should the Registry be operated by the Public Authority or contracted out? 2) Should the Registry serve private pay consumers and providers as well as IHSS consumers and providers? After careful consideration, the group decided that having the Public Authority operate the Registry would afford the greatest level of consistent adherence to the desired philosophy, consistent application of policies and procedures and quality control measures, and consistent collection of reliable performance/evaluation data. With the Registry being operated centrally by the Public Authority, the Team recognized the need for off-site locations to facilitate provider intakes, interviews and orientation. In addition, recognizing that the Public Authority was developed to serve the IHSS population, the Team believes that the Registry should serve only IHSS consumers and providers. Recommendation 8: The Implementation Team recommends the following regarding design of the Registry. 8-1: Adopt proposed recommendation that the Registry be centralized and operated "in-house" by the Public Authority. 8-2: Adopt proposed recommendation that the Registry provide a sufficient number of off--site stations to accommodate provider intakes, interviews and orientation. 8-3: Adopt proposed recommendation that the .Registry serve only IHSS consumers and providers. 17 8-4: Adopt proposed recommendation that the Registry use registry software and forms previously developed by the County,with the understanding that once the Public Authority Registry begins operating, needed software modifications may be identified, The Team further recommends the following modifications: a) To the Provider Intake Form. - question regarding willingness to provide "protective supervision" b) To the Consumer Intake Form - question regarding need for "protective supervision" Registry Operations and Policies and Procedures In considering Registry Operations, the Team chose to format the recommendations as policies and procedures. The policies and procedures cover all aspects of Registry operations. The policies and procedures were developed with considerable input from three public forms held throughout the County and through research of successful practices being used by other public authority registries. There was one significant area where the Team did not include a recommendation made by many attending the public forums. After extensive discussion and research, the Team decided to recommend, that initially, criminal background checks not be included as a component of Registry screening. This decision was based on a number of factors including, the possibility that the State Legislature will be addressing this issue in the future; the time it takes to ,get results of a criminal background check.; the fact that Registry screening will include reference checks; and the relative value of doing criminal background checks vs. the value of doing reference checks. ° In addition, the Team's decision was influenced by the fact that there is a California law, Assembly Bill 857,11 that allows IHSS consumers (as the employer) to ask their provider or potential provider to get a criminal background check. As the employer, the consumer is responsible for paying for the check; and all counties are required to notify IHSS consumers regarding their rights under this law. The Team does recommend that Registry staff inform consumers of their rights under AB 857 and that these efforts be coordinated with the County's plan for notifying consumers regarding AB 857. The Team further recommends that the possibility and value of doing criminal background checks, as a component of Registry screening, be reevaluated as new information becomes available. 10 APPENDIX J-Reference to Department of Justice study st APPENDIX K-Assembly Bill 857 18 Recommendation 9: 9.1: Adopt proposed recommendation on Provider Recruitment Policy and Procedure. The Implementation Team recommends the following Provider R mutment Policy anal Procedure: Policy: The Registry will endeavor to recruit a sufficient number of providers to meet local consumer needs. Procedure: 1. As specifically as possible, identify the tasks/days/hours consurners require; and identify cultural/language and geographic needs and consumer preferences. .Nate: Making these decisions in advance will narrow the focus of recruitment efforts. 2. Recruit providers who meet the tasks/days/hours, cultural/language and geographic needs and consumer preferences that have been identified. Caution: The first inclination will be to recruit as many providers as possible. Be careful; this requires balance. If the Registry doesn't recruit enough providers, it will not be able to meet consumer requests. However, if the Registry recruits too many providers, they will go without work, become discouraged, drop off' the Registry, and word of mouth will hurt future recruitment. 3. Depending on recruitment goals one or more of the following recruitment strategies may be helpful: ■ Utilizing county list of all current IHSS providers and consumers, do an outreach/recruitment mailing; • Asking SEIU to assist in outreach/recruitment of potential providers; • Scheduling informational meetings for potential providers; ■ Advertise in major newspapers, local weekly,and ethnic newspapers; ■ Public Service Announcements on major television and radio stations, cable stations, and ethnic stations; ■ Mailings to and posters in organizations providing services to the elderly and disabled; ■ Posters in busses and trains; • Outreach/recruitment through GAIN, CalWORRs,etc.; ■ Listing Registry with Employment.Development Department; • Outreach/recruitment through churches; and • Outreach/recruitment through colleges. 19 9-2: Adopt proposed recommendation on Provider Application and Intake Policy and Procedure. The Implementation Team recommends the fallowingProvider_ Application and In-take Poligy od Procedure: Provider Application Policy: Providers interested in being placed on the Registry are required to complete a written application, including a list of at least three employment references and two personal references. ■ Purposes of the application include: 1) getting information needed to begin determining the appropriateness of the applicant for the Registry, and 2) getting information needed to make a.match between the provider and.consumer. Application Procedure: 1. Applications can be obtained from the Public Authority Registry. 2. Upon completing and returning the application to the Registry,applicants are scheduled for a personal interview/orientation with Registry staff: Provider Intake Process Policy: All applicants to the Registry are required to participate in the provider intake process;no exceptions will be considered. Intake Procedure: The provider intake process includes the applicant: 1. Completing, signing and dating the provider application. 2. Showing proof of citizenship or any other legal document to work in the United States(Green Card or'Work Permit from the Immigration Department),current and accurate picture identification and Social Security card. The names on the picture ID and Social Security card must match. 3. With.Registry staff, completing the I-9 Form. 4. Signing and dating the signature page of the Provider Handbook, indicating the provider has read and understood the Handbook. A copy of the signed and dated signature page is to be kept in the provider's file. 20 5. Signing permission for the Registry to conduct a criminal background check. Although a criminal background check will not generally be done, giving permission for the Registry to conduct a criminal background check is required. 6. Providing references that meet Registry references check criteria.. The references must include names and telephone numbers of the individuals providing the references. 7. Participating in a face-to-face interview/orientation with Registry staff. 8. Providing documentation/certificates for any training(e.g., First Aid, CPR, CNA or any other training)claimed by the provider. Copies of training documentation/ certificates will be kept in provider's file. 9. Providing proof of valid driver's license and current insurance, if provider indicates a willingness to provide transportation services,. Copies of driver's license and current 'insurance will be kept in provider's file. Consumers will be advised that the Registry only checks these documents at the time the provider goes on the Registry, and that the Public Authority/Registry cannot guarantee that a provider has a valid driver's license or insurance at the time of referral. Providers will be informed that they may be liable if they drive a consumer; that the Public Authority accepts no liability related to a provider driving a consumer; and that the provider should consult with his/her insurance carrier before transporting a consumer. 10. An individual file is to be kept on each applicant to the Registry. Applicants who do not meet the requirements for inclusion on the Registry are to be kept separate from active files, but all documents will be retained for a period of time determined by County Counsel. ■ The provider's file should contain,but may not be limited to: ✓ Completed Registry application ✓ Signed and dated Provider Handbook signature page Completed reference check forms ✓ Completed I-9 form -/ Copies of training documentation/certificates ✓ Copies of drivers license and current insurance Other pertinent information, e.g., if applicant is rejected by the Registry or if a provider is removed from the Registry, a copy of the letter informing applicant/provider of Registry action 21 9-3: Adopt proposed recommendation on Provider Screening - Employment Eligibility Policy and Procedure. The Implementation Team recommends the following Employment Eligibility Potip and Eroodure: Policy: All Registry applicants will be required to complete the I-9 employment eligibility verification process. The 1-9 form must be completed by the Registry staff and signed by the applicant. Copies of personal identification documents must be attached to the forth and included in the applicant's file. Procedure: To complete the I-9 form, the applicant must provide either one document from List A; or one document each from List B and List C ' IQ's A: U.S. Passport; Certificate of United States Citizenship; Certificate of Naturalization; unexpired Foreign Passport with attached Employment Authorization; Alien Registration Card with photograph ■ Ljs : A state issued driver's license or I.D. Card with a photograph ■ .List Q: Original Social Security Card; U.S. Birth Certificate; unexpired INS Employment Authorization 1. The I-9 form must be completed by Registry staff person and signed by the applicant. 2. Copies of all documents must be placed in applicant's file. 3. If the applicant is between 14-17 years of age, she/he must also bring a valid School Work Permit. 9-4: Adapt proposed recommendation on-Provider Screening ® Provider References Policy and Procedure. The Implementation Team recommends the following Provider References Po icy and Proceed Policy: The Registry will require two positive work references and one positive personal reference before considering a potential provider for the Registry. 22 Procedure: Registry staff will: 1. Rewire potential providers (including any providers on the Registry when the Public Authority begins operations)to provide references; 2. Ask potential providers to supply a total of three work references and two personal references, 3. Check references; 4. Require two positive work references and one positive personal reference before considering a potential provider for the Registry,and 5. Include references with the lists sent to consumers and encourage consumers to also check references. 6. Address the situation of potential providers who do not have any or a sufficient number of references (e.g., may be entering the workforce for the first time, have not worked before, or have recently entered the country) as follows: Assuming all other information indicates the potential provider will make a good candidate for the Registry, the provider will be put on the Registry and his/her file will identify the provider as being in an orientatiowa pending status. In consultation with the IHSS Social Worker, these providers will be referred to less vulnerable consumers. The consumer will be clearly informed of the status of the provider. After the provider has successfully worked for one or more consumers for a period of 60 days, these consumers will be asked to provide references. Once the provider has a sufficient number of references, the provider will be taken off orientation/pending status. 9-5: Adapt proposed recommendation on Provider Screening - Provider Interview/Orientation Policy and Procedure. The Implementation "Team recommends the following Provider InlmiewlOrientation Policy and Procedr re: Policy: All Registry applicants will be required to participate in a face-to-face interview/orientation with Registry staff prior to being listed on the Registry. Procedure: 1. Registry staff'will schedule the interview/orientation with the Registry applicant. Interviews/orientation can be done individually or in a group session. 23 2. The interview/orientation will be utilized: ■ As an orientation to IHSS and Registry policies and procedures, e.g., Registry's nondiscrimination policy, what is and what is not allowable in IHSS, IHSS payroll and time sheets, ability of Registry to combine part-time assignments into full-time work; ■ To distribute and review the Provider Handbook;* and to have the provider sign and date the Handbook signature page indicating she/he has read and understood the Handbook; ■ To inform providers about provider and consumer rights and responsibilities; ■ To inform providers that they may be liable if they drive a consumer, that the Public Authority accepts no liability related to a provider driving a consumer and recommending that the provider consult with his/her insurance carrier; • To provide an understanding of the population the provider will be serving; = To stress the importance of reliability, dependability, flexibility, being a good listener and confidentiality; ■ As an opportunity for Registry staff to acquaint themselves with the provider; ■ To review the provider's work history; • To provide written orientation materials, including the Provider Handbook; ■ To assist the provider in understanding and completing the Registry Provider Application; and ■ To provide the opportunity for Registry staff to check and copy (I-9) documentation verifying the provider's legal right to work in this country. 3. The interview/orientation format should include visual, verbal and written presentation. DOTE: The Provider Handbook should include, but may not be limited to: ✓ Registry policies and procedures ✓ provider and consumer rights and responsibilities ✓ suggestions about what the provider might ask in an interview ✓ a list of phone numbers to call if provider has a question or is having a problem,e.g., Registry staff, IHSS staff,payroll 4. A copy of the signed and dated Handbook signature page will be kept in the prov'ider's file. S. The Handbook will be distributed to all newly enrolling IHSS providers, all providers applying to be listed on the Registry and to others upon request. 9-6: Adopt proposed recommendation on provider health screening. In developing this recommendation, the Implementation Team addressed the following: Since providers, in many cases, are working for a vulnerable population, would it not be advisable to do some level of screening providers for communicable diseases before referring them to consumers? 24 Team members realize this is a complicated issue, requiring more study. Therefore, the Implementation Team recommends. ■ That Public Authority staff and Advisory Committee members meet with social workers, Public Health staff, providers and other interested parties to explore/study this issue; and, if needed, develop a policy and procedure to address the issue. 9-7: Adopt proposed recommendation on Provider Follow-up Polio and Procedure. The Implementation Team recommends the following Provider Folio up lice , and Policy. Providers must keep the Registry updated on their schedules, availability for work and other pertinent information. To remain actively listed on the Registry, providers must update their files at least every two weeks, and more often if there is a change in the provider's schedule,availability for work or other pertinent information. Procedure: 1. Registry staff will inform providers that it is the provider's responsibility to update his/her file at least every two weeks, and more often if there is a change in the provider's schedule, availability for work or other pertinent information. 2. Registry staff will inform providers that if they fail to update their files, they will be put on inactive status and will not be referred for future jobs until the file is updated; and that continued non-compliance with the file update requirement will result in the provider's file being closed. 3. Registry staff will inform providers that information to be updated includes: IN Change of provider address or telephone number ■ Changes in availability for work or work preferences, e.g., change in available hours, when a job has ended, when she/he becomes available for new or additional work assignments ■ Notifying Registry if there is an emergency, if they are sick or any other reason she/he will be unable to fulfill work assignments ■ Whenever possible giving two weeks notice if she/he will not be able to continue working her/his schedule 4. Registry staff'will record provider update calls and will make appropriate changes in the provider file and Registry database. 5. Providers whose updates are current will be given priority for job referrals. 25 6. For providers who fail to meet the update requirements: • Registry staff will attempt to contact the provider three tames. ■ If after three attempts the provider has not updated his/her file, staff will send a letter informing the provider that his/her file has been closed;and • Informing the provider that his/her file may be reactivated if/when the update is completed. 7. The reactivation process a provider will go through of she/he has been inactive on the Registry for a period of time exceeding 6 months will depend on the particular situation and will most often be at the discretion of Registry staff. This process may include, but not necessarily be limited to: ■ Staff'exploring with the provider the reason(s)for inactivity on the Registry ■ Re-checking references • Re-interviewing and orientation of provider 9-8: Adopt proposed recommendation on Provider Removal from the Registry Policy and Procedure. The Implementation Team recommends the following Provider R moy-a1_ from the R Qgi try.Policy and Proce : General Policy: ■ The Public Authority reserves the right to remove a provider from the Registry. ■ The Public Authority may determine reasonable rules and regulations regarding the appointment to and removal of providers from the Registry. ■ Complaints concerning a provider may be given verbally or in writing to Public Authority staff. Public Authority staff will document all complaints. Policy-Minor Offenses: The Public Authority will remove a provider from the Registry after two complaints of manor offenses that have been reported by one or more sources within a two year period and have been deemed valid by Public Authority staff; Minor offenses will include but not be limited to: ■ Not appearing at scheduled interviews without notice • Being late for work without reasonable cause • Discourtesy, rudeness or inappropriate behavior toward consumer or consumer relatives or Public Authority staff • Refusal to do the authorized tasks agreed to upon hire E Not performing requested and authorized tasks during work hours • Inadequate,job performance 26 ■ Not returning consumer phone ells = Not returning Registry phone calls • Failure to update Registry files = Quitting Registry assignment(without a good reason) without at least a two week notice Policy-Major Offenses: The Public Authority will remove a provider from the Registry after one complaint of a major offense that has been deemed valid by Public Authority staff. Major offenses will include but not be limited to: = Theft = Sexual/physical abuse = Neglect = Dishonesty or misrepresentation related to job duties ■ Unauthorized disclosure of confidential information Being intoxicated or being under the influence or possession of any illegal substance while on duty = Asking the consumer to supplement the allowable IHSS wage = Absence from or leaving the job without notice Possession of a firearm or other dangerous weapon while on duty = Conviction for a crime which indicates unfitness for the job = Knowingly putting the consumer in jeopardy Procedure: 1. Public Authority staff will evaluate the complaint and determine what action to take. 2. If the complaint regarding a first minor offense is determined to be valid, by Public Authority staff, the provider will be mailed a written statement listing the complaint,notifying the provider that a second complaint of a similar offense will constitute grounds for removal from the Registry, and informing the provider about the appeal process. 3. If a complaint regarding a second aninor ,aril (within a two year period) or a complaint regarding a mai-or offense is determined to be valid, by Public Authority staff,the provider will be removed from the Registry. 4. Within ten working days following the date of Registry removal, the provider will be availed a written statement notifying the provider of the removal, the reason(s) for removal, and informing the provider about the appeal process. 27 Appeal Process: 1. The provider may appeal the Public Authority's action to the Public Authority .Executive Director within ten working days of mailing of the removal notification letter. The appeal must be in writing and state why the provider believes the Public Authority's action was incorrect. The Executive; Director has the discretion to extend the ten working days timeframe if she/he deems it appropriate and reasonable to do so. 2. The Executive Director will mail the provider written notification of his/her decision within ten working days of receipt of provider's appeal. 3. If the provider is not satisfied with the Executive Director's decision, the provider can bring the appeal, in writing, to the Advisory Committee or subcommittee of the Advisory Committee within thirty working days of mailing of Executive Director's decision.. 4. The Advisory Committee or subcommittee will make the final decision regarding the appeal within thirty working days of receipt of provider's appeal. The thirty working days timeframe can be modified with the mutual consent of all parties. 5. Providers removed from the Registry will remain in an inactive Registry status (not being referred to jobs)until/unless the decision to remove is reversed through the appeal process. 9-9: Adopt proposed recommendation on Referral of Consumers to the Registry Policy and Procedure. The Implementation Team recommends the following Referral of Conau er to the Regis�ay prof&dure. Policy: The Registry accepts referral of any Contra Costa County IHSS consumer from any referral source. Primary referral sources: • Initial (first time)referrals generally come through County IHSS. • Some initial referrals may come from others,e.g., family members, providers. ■ Re-referrals (those who have been previously served) are most often direct self- referrals. elfreferrals. 28 Procedure: When a referral is received, Registry staff will: 1. Contact the consumer or consumer representative within three working days; 2. Confirm consumer's IHSS status, and 3. Begin the intake process 9-10: Adopt proposed recommendation on Consumer Intake Policy and Procedure. The Implementation Team recommends the following _ onswm__er Intake Policy and Policy: A written Intake Form will be completed on every consumer requesting services from the Registry. ■ Purpose of the Intake Form is to get information needed to match providers and consumers. Procedure: Once a referral is received, Registry staff will: 1. Contact the consumer or consumer representative within three working days; 2. Confirm consumer's IHSS status; 3. Describe how the Registry works; and inform the consumer that she/he is responsible for selecting a provider; 4. Inform the consumer that, within five working days, the Registry will provide a list of providers for the consumer to consider; and that in an emergency situation the Registry will get names of providers to the consumer as quickly as possible; 5. Inform the consumer that she/he is not obligated to hire a provider from the Registry; that consumers have the right to seek providers from any source, including but not limited to referrals from the Registry; and, if appropriate, suggest other possible sources of providers, e.g., family member, friends, church; 6. Inform the consumer that she/he will need to respond to a series of questions in order to facilitate referrals from.the Registry; 29 7. Fill out consumer Intake Farm, identifying, with the consumer, his/her most critical needs and most important preferences; and 8. Obtain consumer's most current 293 form from the IHSS Social Worker, and attach the 293 to the intake. In addition, some Implementation Team members felt it was important that providers know if a consumer they were, or potentially would be, serving had a communicable disease. The Team's discussion of this issue included: ■ a concern for consumer confidentiality; ■ the need to train providers regarding the use of Universal Precautions; • the need to encourage consumers to voluntarily disclose, to their providers, as , much as possible about their condition; and ■ the need to investigate and address the possible transfer of communicable disease. The Team did not have time to thoroughly review this topic or to make a specific recommendation on how best to address this issue. However,the Implementation Team recommends: • That Public Authority staff and Advisory Committee members meet with social workers, Public Health staff, providers and other interested parties to explore/study this issue; and, if needed, develop a policy and procedure to address the issue. 9-11: Adopt proposed recommendation on Generating Consumer List of Providers Policy and Procedure. The Implementation Team recommends the following C&umtng Qonsumer List of Providers Policy and Pro-cedure: Policy: ■ Consumers or consumer representatives will be given a list of providers from the Registry. The list will include a minimum of three and a maximum of six providers. • The order of screening to determine which providers are placed on the list will be based on making an appropriate match between the consumer's needs and preferences, and the provider's willingness to perform tasks authorized by the social worker and the provider's availability and preferences. • The Registry reserves the right to continue screening for consumer needs and preferences and provider preferences until the provider list consists of at least three and no more than six names. 30 Procedure: 1. Using information from the Consumer Intake Form, Registry staff will generate a list of providers by querying the Registry database for providers who match the consumer's needs and preferences; 2. Registry staff will also query for providers who are willing to perforin tasks authorized by the social worker and who are available for work; 3. Registry staff will query such that the list will include a minimum of three and maximum of six providers; and 4. The list will only include providers who have completed the application process, including reference check, I-9 and, if applicable, provided training documentation or certification, proof of valid driver's license and required insurance. 5. Providers who do not have any or a sufficient number of references (e.g., may be entering the workforce for the first time, have not worked before, or have recently entered the country)may be included on the list under the following conditions: ■ All other information indicates the provider is appropriate to be included on the list; and the provider has been put on the Registry in an orientation/pending status; after consultation with the IHSS Social Worker it is determined that the provider is an appropriate referral for his/her consumer; and the consumer is clearly informed of the status of the provider. 6. If the consumer needs a provider with special training (e.g., First Aid, CPR., CIA.), Registry staff will assure that appropriate training documentation/certification is on file prior to including the provider on the list. 7. If the consumer needs a provider to provide transportation services, Registry staff will assure that proof of a valid driver's license and insurance are on file prior to including the provider on the list; and Registry staff will inform the consumer that proof of license and insurance were checked at the time of provider's application to the Registry, but that the Public Authority/Registry cannot guarantee that a provider has a valid driver's license or insurance at the time of referral; and that the Public Authority accepts no liability related to a provider driving a consumer. 8. The list will only include providers who have indicated a willingness to perform the tasks/hours the consumer needs and, as much as possible, meet other preferences desired by the consumer. 31 9-I2t Adopt proposed recommendation on Referral of Providers to Consumer Policy and Procedure. The Implementation Team recommends the following Refer` 1 sof Providgm to ns= o i y and Pro dam' Policy • The Registry will supply a list of providers to IHSS consumers following completion of the consumer intake process. The list will include a minimum of three and a maximum of six providers. The order of screening to determine which providers are placed on the list will be based on snaking an appropriate match between the consumer's needs and preferences, and the provider's willingness to perform tasks authorized by the social worker and the provider's availability and preferences. • The list will be communicated to the consumer or consumer representative. It is the consumer's (or person acting in the interest of the consumer)responsibility to choose which provider(s)if any, she/he will contact and/or hire from the list. • The Registry will not"recommend"any provider(s). k The consumer is the employer for the purposes of hiring, supervising and firing his/her provider. The&gislty is aQt th lo fQr JUse fumtions. Procedure: 1. After the list has been generated from the Registry database, .Registry staff will "pre-screen" the list of providers for availability and interest prior to communicating the list to the consumer. The steps in pre-screening include: a) Calling the providers on the list; with each provider you reach, describing the jab in general terms (do not give any specific identifying information about the consumer); b) Ask if the provider is interested in the job and if and when she/he would be available to hear directly from the consumer; c) When you have received three positive responses, communicate these provider's names and numbers to the consumer by phone; indicate to the consumer that you have talked to these providers and that they are interested in the job; d) Inform the consumer that there are others on the list who had not been called and that the full list will follow in the mail, but that they may want to begin calling the(pre-screened.)names; 32 e) Remind the consumer that it is his/her responsibility to choose and hire the provider; and remind the consumer that 1he pre-scree=d. namesars; nnly Mtions onnrovider availability and ale not' to b e seen as recornmendatiom from the Registry. 1. After the list has been pre-screened and the pre-screened provider's names and numbers have been communicated to the consumer by phone, the full list of providers is to be mailed to the consumer. Additional materials to be included in this mailing may include,but will not necessarily be limited to: ■ Information on how the Registry operates, including what the Registry does and does not do; • IHSS recipient and provider rights and responsibilities; • Other relevant printed materials. 2. Registry staff will inform the consumer that she/he should call the Registry to let staff know if she/he has hired a provider or is having any problems with the process. 3. Registry staff will inform the consumer that the provider must call the IHSS Social Worker to begin the provider enrollment process. 9-13. Adopt proposed recommendations on addressing urgent and emergency needs. The Implementation Team believes that the Public Authority should address both urgent and emergent needs in the Registry design.. Relative to this belief, the Team recommends: i The Public Authority staff and Advisory Committee develop a method for identifying and addressing urgent and emergent needs within the first year of operations; • That the program be designed in coordination with the Social Service Department; ■ That when designing the program, the staff and Advisory Committee review what other Public Authorities have developed; • Explore existing community systems (e.g., Linkages, MSSP) that might assist in provision of services; • Explore options for contracting out the service; and ■ Clearly assess/address the liability risk of contracting for, or making direct referrals for, urgent and emergent needs. 33 9-14: Adopt proposed recommendation on Consumer Follow-up Policy and Procedure. As reflected in the following Consumer EoIIQMLQ policy an . ro�ecl. ure, the Implementation Team recommends: * The use of a consumer satisfaction survey. The survey would be conducted each time a Registry case is "closed"; and ■ The use of a survey to determine consumers' satisfaction with their Registry providers. This survey would be conducted after the provider had been on the job for 60 days. • The Team f irther recommends that questions to be asked on the surveys be determined. (in part) by the performance measures adopted by the Public Authority, and that development of the surveys be dune by Public Authority staff and the Advisory Committee in coordination with the Social Service Department. The Implementation Team recommends the following Co,on er Fol ow-L- Po icv and roced=: Policy: The Registry will provide regular follow-up on all consumer's receiving a list of providers from the Registry. Follow-ups will be conducted by placing telephone calls to the consumer or consumer representative. Follow-up telephone calls will be made at least every ten days and will continue until the consumer case is closed, e.g., consumer found Registry provider or found own provider, consumer hospitalized, institutionalized, withdrew or was withdrawn from IHSS or deceased. Purposes of follow-up include, but are not limited to: assessing consumer's progress in finding a provider; and determining if the consumer is having any particular problems in utilizing Registry services, if consumer needs have changed, if consumer needs a new list, or if consumer needs additional support services. Procedure: I. Once the list of providers has been mailed to the consumer and the appropriate information entered into the Registry Tracking database, the database will automatically indicate the date for the first follow-up call. 2. On the date indicated for the first follow-up call, place a phone call to the consumer to determine the consumer's progress in finding a provider, if the consumer is having any particular problems in utilizing Registry services, if the consumer's needs have changed, if the consumer needs a new list, if the consumer needs additional support services,etc. 34 Additional yup services include. but aye not necessarily Limited to: • Assisting the consumer and provider with understanding employer/employee roles,rights and responsibilities; ■ Understanding how to interview and hire providers; • Calling providers and setting up interviews; • Being present at interviews; • Assisting with resolution of conflict between provider and consumer; • Developing provider schedules and tracking of provider's hours; • Understanding payroll,time sheets and share of cost payments; ■ Trouble-shooting payroll and share of cost problems; and ■ Referring consumers to Special Needs Desk. 3. After completing the follow-up call, Registry staff will consult with the social worker and take whatever steps are appropriate to address issues/problems identified while speaking with the consumer. 4. The next step is to enter the appropriate information (follow-up notes) into the Registry Tracking database, the database will automatically indicate the date for the next follow-up call. 5. The final step is to print out two copies of the Registry Tracking form, i.e., one for the social worker and one to be used during the next follow-up call. 6. After a case is closed, the consumer will be asked to respond to a Consumer Satisfaction Survey. The survey will be conducted over the phone by Registry staff (preferably staff that has not had ongoing contact with the consumer). Written copies of completed surveys will be kept on file. The surveys will be used as a tool for assessing Registry performance and progress toward meeting Public Authority Performance Measures, for identifying needed program improvements and for reporting to the Advisory Committee and Board. 7. After a Registry provider has been on the job for 60 days(the match has lasted 60 days) the consumer will be asked to respond to a survey to assess the quality of their provider's work. The survey will be conducted over the phone by the Registry staff (preferably staff that has not had ongoing contact with the consumer). Written copies of completed surveys will be kept on file. The surveys will be used as a tool for assessing Registry performance and progress toward meeting Public Authority Performance Measures, identifying provider training needs and for reporting to the Advisory Committee and Board. 35 9-15. Adopt proposed recommendation on potential exclusion of consumers from Registry services. In considering this recommendation, some Implementation Team members raised the question: Should there not be a policy and procedure for excluding consumers from Registry services if the consumer engaged in certain dangerous/problematic behaviors, e.g., having been convicted of a violent crime, convicted of committing sexual abuse,declining to pay share of costs? While the Implementation Team did not agree on a recommended policy and procedure addressing this issue,the Team does recommend that: 1. Public Authority staff and Advisory Committee members meet with social workers, Public Health staff, providers and other interested parties to determine how best to address this issue; and 2. If needed, the Public Authority develop a policy and procedure that would exclude consumers from Registry services for certain dangerous/problematic behaviors. 36 .............................................................. ................. ............................................................................................... _.. ......... ......... ............ ............... .. _. ......... ......... ......... ........... ............................._...... _ ......... ......... .......... ............................ ....._.... __ CHAPTER SIX FINDINGS AND RECOMMENDATIONS Consumer and Provider Support Services and Consumer and Provider Training Introduction This section of the Implementation Team's report presents findings and recommendations regarding Public Authority consumer and provider support services and consumer and provider training. In developing the recommendations included in this section, Team members considered information included in the January 27, 1998 staff report, County Ordinance No. 98-14, Public Authority statutes and regulations, community input and practices of operating public authorities. Consumer and Provider Support Services The recommendation on consumer and provider support services were developed with considerable input from three public forms held throughout the County and through research of successful practices being used by anther public authorities. The Implementation Team agreed that the goal of providing supportive services is to assist in achieving and maintaining a match between the consumer and provider. Recommendation 10: Adopt proposed recommendation on consumer and provider support services. The Implementation Team recommends that: ■ The Public Authority provide supportive services; • Support services be provided to any Registry consumer or provider upon request, and determination of need by Authority staff; • When appropriate (e.g., payroll problems, share of cost problems, referral to Special Needs Desk) social worker notification/coordination will tape place;and • Methods for provision of services would include phone consultation, written materials, inclusion in consumer/provider orientation and training and home visits. The Implementation Team further recommends that supportive services include, but not necessarily be limited to: ■ Assisting the consumer and provider with understanding employer/employee roles, rights and responsibilities; • Understanding how to interview and hire providers; • Calling providers and setting up interviews; ■ Being present at interviews; • Assisting with resolution of conflict between provider and consumer; 37 • Developing provider schedules and tracking of provider's hours; ■ Understanding payroll,time sheets and share of cost payments; ■ Trouble-shooting payroll and share of cost problems; and ■ Referring consumers to Special Needs Desk. Consumer and Provider Training Public Authority Regulations require that the Public Authority "provide access to training for providers and recipients." This could mean as little as providing information on training opportunities in the community. However, after considerable public input on this topic, reviewing successful practices being used by other public authorities and Team member's desire to, as much as possible, work to upgrade provider skills, the Team recommends the Public Authority develop and provide training for consumers and providers. Recommendation 11: Adopt proposed recommendation on Consumer and Provider Training Policy and Procedure. The Implementation Team recommends the following Con mer and Provider Training Policy and Procedure: Policy: Training services will be made available to all IHSS consumers and providers; training will be provided upon request and determination of need by Public Authority staff; training will be voluntary and at no cost to consumers or providers; training and training materials will be provided in English and other appropriate languages. A stipend will be paid to enrolled Contra Costa County IHSS providers and active Registry providers for attending group training sessions. Procedure- Consumer Training: ■ Consumers receive training/orientation to IHSS and Registry services during the intake process and through printed materials. • Consumer training will be done one-on-one and in group sessions; and training topics will include, but may not be limited to clarification regarding IHSS, consumer/provider rights, roles and responsibilities, how to be an employer, e.g., hiring, firing, supervising, scheduling, timecards, dealing with employee problems. (One-on-one training usually takes place in the consumer's home.) ■ If requested by the consumer, and Public Authority staff has determined a need, consumer and provider will receive specific (task/skill oriented) on-the-job training. (This training usually takes place in the consumer's home.) 38 ................................................................. ........................................................................................................................................................................... ...._ ......... ......... ......... ............. .... ..............._..................................... ........ ...... ......... ......... ............................................._..... ................ _ _ _ _ ........ .............................................................. ■ A record is to be kept of all one-on-one and group training received by consumers. Procedure—Provider Training: • Providers receive training/orientation to IHSS and Registry services during the intake (interview/orientation)process and through printed materials. • Provider training sessions will be offered. Training sessions will: V Be in a group setting, 25-30 participants per session, Be scheduled at different locations throughout the County; at different times of day and evening; and V Training topics will be general, e.g., Universal Precautions, back care, transferring, CPR, First Aid,adaptive equipment use. • A record is to be kept of providers attending group and/or individual training; and completion of training is to be noted in the provider's Registry database file. 39 CHAPTER SEVEN FINDINGS AND RECOMMENDATIONS Public Authority Executive Director Reporting Structure, Staff Positions,Job Descriptions,Salaries and benefits, Office Space,Performance Measures,.budget and Rate, Documentation Required by the California Department of Social Services Introduction This section of the Implementation Team's report presents findings and recommendations regarding the Public Authority Executive Director reporting structure, staff positions, job descriptions, salaries and benefits, performance measures, office space, budget, rate and documentation required by the California Department of Social Services. In developing the recommendations included in this section, Team members considered the Public Authority services recommended in previous chapters of this report, information included in the January 27, 1998 staff report, County Ordinance No. 98-14, Public Authority statutes and regulations, community input and practices of operating public authorities. Public Authority Executive director Reporting Structure When considering this issue, the Team endeavored to answer the basic question: To wham does the Executive Director report? To address this question, the Implementation Team was not asked to make a specific recommendation, but was asked to list the pros and cons of a number of reporting options. Before listing these options,Team members agreed. • That the Governing.Board appoints the Executive Director; • The Executive Director works for the Governing Board; • That the Executive Director reporting structure would not affect the Advisory Committee's role, i.e., advisory to the Governing:Board and staff of the Public Authority; and ■ That the Governing Board may choose to delegate supervision of the Executive Director to another department. In addition, Team members found the following to be important considerations when deciding on the Executive Director reporting structure: • The entity/person to which the Executive Director reports should be to the Executive.Director and hmwWgohk about Public Authority programs and issues; • There should be a clear understanding of the respective roles and responsibilities of the entity/person to which the Executive Director reports and the Executive Director; ■ That there are two types of reporting, i.e., on day-to-day program issues and on "bigger picture"policy and advocacy issues; • That there could be two entities to which the Executive Director reports, i.e., 1) on day- to-day program issues 2)on policy and advocacy issues; 40 ■ That, regardless of any other reporting structure, it is essential that the day-to-day reporting/liaison regarding program issues be to the Social Service Department, and f That reporting thmah an entity should not preclude direct contact between the Executive Director and Governing Board and/or regular (semiannual/annual) reports to the Governing Board. The Implementation Team considered the pros and cons of the following options: 1. Reporting directly to the Governing Board; 2. Reporting through a committee of the Governing Board; 3. Reporting through the County Administrator's Office; and 4. Reporting through the Social Service Department Reporfing Direcft to the Governing Board Pros, Cons Would be reporting directly to Board may not be as accessible the legal entity: the Public Authority(PA) as needed The PA model allows for direct access With all issues Board has before it, to the Board PA issues might not get attention/ focus needed Message from PA staff would be direct and clear;not through a third party Might encourage micro-management by the Board Would allow for sharp focus on PA issues There is no need for small group to Would put issues directly before the Board have a"special"relationship with for decisions Board;relationship established through the interagency agreement could Provides opportunity to keep Board be sufficient directly informed/educated on PA issues A direct connection to the Board would give the Board the opportunity of staying better informed in making PA program and policy decisions ReportingThrough"Committee of t e Governing Raard Eros CQns Might be more accessible Committee can't make independent than the Board decisions 41 roorting through a CQmt i of t eCoy mi Board conte: Pros cons Would have access to the Board, i.e., Having an entity between the two Board members sit on the committee Executive Director and the Board might tend to dilute presentation of PA issues Might provide greater access to the Board PA issues might not be a priority than going through County Administrator considering other issues the or Social Service Department Committee could be addressing Committee has ability to get items on 'Timing might be a problem in the Board agenda, getting on the Committee agenda Having to go through a Committee might imply not having full access to the Board RepoWng T ro ugh County Arun_ in_`stratar's Office Pros Cons Could be helpful in navigating the Very busy: might be hard to get County system; "opening doors" attention, could be delays in getting PA issues addressed Has bread(county-wide)perspective Having to deal with competing interests/priorities might tend to delay or dilute importance of PA issues Not as accountable as an elected official Repgrfi Thro.. gkSagi $&nice DepArtmgnt Pros Cons Less confusion: Executive Director(ED) Role of ED could become reports to same entity for day-to-day confused, i.e., seen as employee program and policy and advocacy issues of Social Service Department(SSU) 42 = �=u .'aServi =atW1 nt_comin=d: Pros Cons Advantage to reporting falling under, Having to deal with competing flowing through, umbrella of SSD interests/priorities might tend to delay or dilute importance of PA Advantage to not having two"bosses" issues Advantage of reporting structure Potential of SSD issues taking paralleling funding flow:through SSD priority over PA issues Could mitigate potential of Board Going through SSD is another step to micro-managing the PA go through to get issues in front of the Board If needed, SSD could run interference; "provide protection"for PA staff and services Public Authority Staff Positions,Job Descriptions,Salaries and Benefits In considering Public Authority staffing, the Implementation Team based the recommendation on staff positions on a formula that has proven valid for operating public authorities, i.e., an Executive Director, Program Manager, Office Manager/Secretary and one full-time equivalent(FTE)Registry/Training Specialist for 500 (annual) requests for Registry providers, registry management and provision of consumer and provider training and support services. Based on the Contra Costa County IHSS caseload this formula indicates a need for 2.5 FTE Registry/Training Specialists. The recommended Public Authority staff job descriptions, salary ranges and benefits were developed with considerable input from the Human Resources Department and are based on job descriptions, salary ranges and benefits for comparable county positions/classifications and on job descriptions, salaries and benefits being successfully used by other public authorities. Recommendation 12: 12-1: Adapt proposed recommendation on Public Authority staff positions. The Implementation Team recommends the following Public Authority staff positions: ■ Executive Director ■ Program Manager • Office Manager/Secretary • Registry/Training Specialist(2.5 FTE) 43 12-2: Adopt proposed recommendation on Public Authority staff job descriptions. The Implementation Team recommends the attached 12 Public Authority staffjob descriptions for: • Executive Director • Program Manager • Office Manager/Secretary ■ Registry/Training Specialist 12-3: Adopt proposed recommendation on Public Authority staff salary ranges and benefits. The Implementation Team recommends the following Public Authority staff salary ranges and benefits: Position Salary Range Executive Director $58,284—$70,836 Program Manager $46,876—$56,976 Registry/Training Specialist $34,308®$41,712 Office Manager/Secretary $27,228—$34,776 The Implementation Team recommends that the Public Authority staff benefit package"mirror"the County employee benefit package as closely as possible. Public Authority Office Space In considering recommendations regarding Public Authority office space,the Implementation Team agreed that the ideal would be to have the Public Authority office co-located with the Social Service Department/IHSS. However, the Team realized it was not possible, at this time,to recommend a specific location for the Public Authority office. While unable to recommend a specific location, the Team has made certain general recommendations, e.g., location, space requirements, accessibility. In developing these recommendations, Team members considered community input and practices of operating public authorities. Recommendation 13: Adopt proposed recommendations on Public Authority office. The Implementation Team recommends the Public Authority main office: !2 APPENDIX L-Recommended Public Authority staff job descriptions 44 = Be centrally located; ■ Have a minimum of 1000 sq. ft., including private office for Executive Director; ■ In addition to 1004 sq. ft. of office space, have access to space for meetings and private space for interviews; ■ Have easy/ready access to Social Service Department/IHSS staff; ■ Be accessible to people with disabilities; and ■ Be accessible by public transportation. Public Authority Performance Measures Implementation Team members strongly agree on the value of performance (outcome) measures for the Public Authority. In developing the recommended performance measures, the Team designed measures that assessed outcomes for Public Authority services, that were realistic, doable and challenging, and were reliant on information that would be readily available/collectable. Sources for this information will include consumer surveys 13 and the Registry database. In developing these recommendations, Team members considered community input and performance measures being used by operating public authorities. As will be seen in the following list of recommended performance measures, the Team decided to not list any percentage outcomes and only listed some of the duration outcomes. The Team believes that these outcomes would be more appropriately set by the Public Authority staff' and Advisory Committee (in consultation with IHSS) once the Public Authority is operational. Recommendation 14.- 14-1: 4:14-1: Adapt proposed recommendations on Public Authority performance measures. The Implementation Team recommends the following Public Authority performance measures: 1. %of consumers will indicate receiving provider referrals within five 14 days of request. 2. %of consumers using the Registry(and following through with Registry process)will find a provider with Registry assistance. 3. %of consumers using the Registry(and following through with Registry process)will find a provider within days. 4. %of consumers will indicate overall satisfaction with registry services. 5. _ °lo of Registry matches will last a minimum of—days. 13 APPENDIX M-sample consumer satisfaction surveys 14 This number of days was included in a previous recommendation 45 6. of consumers will indicate satisfaction with quality of Registry provider job performance. (Survey to be conducted two months 15 following consumer employment of Registry provider). 7. Nine-hundred"providers will receive training through the Public Authority during a one year period. 8. consumers will receive training through the Public Authority during a one year period. The Implementation Team has attached performance measures, including percentage and duration outcomes, used by other public authorities.17 The Team believes this will assist the Public Authority staff and Advisory Committee in establishing percentage and duration outcomes. In addition, the Social Service Director recommends that these performance measures be incorporated into the interagency agreement between the Social Service Department and Public Authority. 14-2.- Adopt proposed recommendation on provider satisfaction performance measure(s) and satisfaction survey. Some members of the Implementation Team raised the issue of the Public Authority having a performance measure(s) related to provider satisfaction and developing/using a provider satisfaction survey. A sample survey 18 was presented to the Team. The Team did not have time to review this survey or to make a specific recommendation regarding an additional performance measure or use of the survey. However,the Implementation Team recommends: ■ That the idea of performance measure(s) related to provider satisfaction, doing a provider satisfaction survey and the sample survey be forwarded to the Public Authority staff and Advisory Committee for future consideration. Public Authority Budget and Rate The consultant prepared the recommended budget and rate and the budget narrative. The preparation of these items was done in consultation with the Social Service Department, Human Resources Department, County Counsel and Risk Management Department. In developing the recommendations included in this section, the consultant considered the Public Authority services recommended in previous chapters of this report, information included in the January 27, 1998 staff report, County Ordinance No. 98-14, Public Authority statutes and regulations, and the budgets of operating public authorities. It should be noted that the budget and rate assume a provider hourly wage of$5.75 per hour. It is understood that this may change in the future; and should this take place, a modification of the budget and rate would be required at that time. Is Number of months was included in a previous recommendation 16 Number of providers was included in the staff report and is accommodated in proposed budget $7 APPENDIX N- Performance measures used by other public authorities APPENDIX 0- Sample provider satisfaction survey 46 Recommendation 15: Adopt proposed recommendation on Public Authority budget and rate. The Implementation Team recommends the attached 19 Public Authority budget and.rate. Documentation Required by the California Department of Social Services Prior to a public authority rate being approved by the California Department of Social Services(CRSS); and as per Public Authority Regulations -prier to initiating the delivery of IHSS through a public authority, the County must enter an interagency agreement between the County and Public Authority and must submit to CDSS a copy of the agreement along with the fallowing information concerning the public authority: ■ Organizational Chart of the Public Authority; • Funding provisions for the Public Authority oasts, including haw proposed rate was developed; ■ Public Authority staffing,classifications and duties; and • How the functional requirements will be met. The interagency agreement between the County and Public Authority,is yet to be developed by County staff. However, the Organizational Chart; ° fundingarovisions and how proposed rate was developed,21 staffing classifications and duties; and how the functional requirements will be me t23 are included with this resort. With the above materials, the County must submit to CDSS a completed rate form. 4 In addition, pursuant to California Government Code Section 53051, the Public Authority must submit, to the Secretary of State, a Statement of Facts Raster of Public Agencies Filing.25 19 APPENDIX P-Recommended Public Authority budget,rate and budget narrative 20 APPENDIX Q-Organizational Chart of the Public Authority 21 APPENDIX.P-Recommended Public Authority budget,rate and budget narrative 22 APPENDIX R-Public Authority staffing,classifications and duties 23 APPENDIX S-How the functional requirements will be met 24 APPENDIX T-CDSS rate form 25 APPENDIX U-Statement of Facts Roster of Public Agencies Filing 47 APPENDIX A IMPLEMENTATION TEAM MEETING GROUND RULES Members will: • Attend,be on time and participate in meetings • Try to leave the past behind • Allow person speaking to finish before starting to speak; but allow for "paints of clarification" • Avoid side conversations Speak loudly enough to be heard by all in attendance ® Recognize need to provide reasonable accommodations Provide suggestions/ solutions along with constructive criticism ■ Not criticize spelling Try not to repeat a point that has already been made ffi Articulate primary interest, while seeing the"big picture" Respect other members' perspectives Deal with issues,not personalities Demonstrate a willingness to negotiate for overall success of project Appreciate that the PA will operate with/within established systems; and the relationship of PA to these system Chairperson will make every effort to rotate those chosen to speak; give everyone an opportunity APPENDIX B IMPLEMENTATION TEAM DECISION MAKING PROCESS • A quorum equals 50% a Consensus will be reached whenever possible • All major items will be decided by a motion-second-majority vote process • Consultant will keep a running list of items the group agrees should be addressed by PA Advisory Committee at a later date • If needed,a minority opinion I report will be included APPENDIX C IMPLEMENTATION TEAM COMPREHENSIVE WORK PLAN OUTLINE Phase I. ■ Meeting with. the Social Service Department Director and other key stare holders to understand and clarify expectations for the Public Authority; ■ Development of an ad hoc Implementation Team.; ■ Finalizing the membership of the Implementation Team; and ■ Implementation. Team to: (1) agree on meeting ground rules and group decision making process; (2) develop and agree on comprehensive work plan for designing the Public Authority; (3)decide on role and membership of the steering committee; and(4) develop a schedule of future meetings and meeting agendas. Phase II. Implementation Team to: (1) understand and agree on the Public Authority's role, responsibilities, authority, relationship and level of coordination with other entities; (2) develop and agree on values and Mission Statement and goals for the Public Authority; and (3) develop and agree on the mission, membership, structure and operations for the Public Authority Advisory Committee. Phase 111. Implementation Team to: (1) reach agreement on Registry design and processes and anticipated workload and staffing requirements; and (2) reach agreement on process and procedures for provider screening and background checks and anticipated workload and staging requirements. Phase IV. Implementation Team to: (1) reach agreement on process and procedures for the referral of providers to consumer and anticipated workload and staffing requirements; (2) reach agreement on process and procedures for provider and consumer training and anticipated workload and staffing requirements; (3) understand and reach agreement on process and procedures for consumer and provider support services and anticipated workload and staffing requirements; (4) understand and reach agreement on division of responsibilities between the Public Authority and IHSS Special Needs Desk; (5) develop options regarding Executive Director's relationship with County; (6) develop options concerning where the Public Authority staff will be located; (7) reach agreement on Public Authority staffing pattern and approve draft job descriptions for Public Authority staff; (8) understand and reach agreement on Public Authority evaluationand performance measures; and (9) consultant to provide final draft Public Authority budget, rate calculations and submission forms. APPENDIX D IMPLEMENTATION TEAM STEERING COMMITTEE Role of the Committee ■ Committee will not make decisions or recommendations; but will advise consultant on meeting agendas, group procedures and processes. Committee Membership • Team Chairperson • Team Vice Chair • Department of Social Services Director or designee • Consultant APPENDIX E IMPLEMENTATION TEAM MEETING SCHEDULE The Implementation Team will met on the I sf and 3,d Thursdays of each month, from 1:40- 4:00, at Aging and Adult Services. Implementation'Team Meeting Dates 1998 1999 September 3 January 7 September 17 January 21 October I .February 4 October 15 February 18 November 5 March 4 November 19 December 3 December 17 APPENDIX F JANUARY 27, 1998 STAFF REPORT 4 TO: BOARD OF SUPERVISORS •x �- ,+�__ '; CONTRA t COSTA FROM: Phil Batchelor, County Administrator . , COUNTY John Cullen, Director Social Service Department DATE: January 27, 1998 ' SUBJECT: In Home Supportive Services (IHSS) Public Authority SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION RECOI tIMENDATI I+ItSI- 1. ACCENT this report responding to the Board Order of July 8, 1997 requesting development of a plan and identification of funding mechanisms for establishment of an IHSS Public Authority. 2. ESTABLISH an IHSS Public Authority pursuant to the draft ordinance (Exhibit 1) as prepared by County Counsel and which: • establishes an independent public authority governed by the Board of Supervisors; • provides for the Board of Supervisors to appoint the Director of the Public Authority; • provides for the establishment of an eleven member Advisory Committee appointed by the Board of Supervisors; • authorizes the public authority to maintain a registry of IHSS providers, • allows for union representation of IHSS providers; = authorizes collective bargaining, • designates the +bounty's Human Resources Department as the manager of labor relations for the public authority; and • limits the financial exposure to the County general Fund by requiring full state participation for public authority operating costs and provider sand benefits. CONTINUED ON ATTACHMENT: —Y'ES SIGNATURE: A,\ RECOMMENDATION of COUNTY ADMINISTRATOR—RECOMMENDATION OF BOARD COMMCTTEE —APPROVE —OTHER SIGNATURE(S): ACTION OF BOARD ON APPROVED AS RECOMMENDED—OTHER The ordinance also provides for a 2 year sunset on the public authority. 3. DIRECT the County Administrator to work with the Social Service Department to identify$70,000 in County General Funds to sort initial implementation activities in the current 1997-98 Fiscal Year. 4. DIRECT the County Administrator to work with the Social Service Director to develop a financing plan to cover the General Fund costs for Public Authority operating costs which are anticipated to be a minimum of$169,400 during the first full year of operation and would be appro)elmately $152,700 on an ongoing annual basis, assuming maximum possible State financial participation. 5. AUTHORIZE and DIRECT the Social Service Director to proceed with implementation of activities by retaining an implementation consultant and convening an implementation work group including all major stakeholders in the IHSS program; i.e., a representative cess-section of IHSS clients and providers, IHSS Task Force members, community representatives and appropriate County staff. BACKC «UNDtREA,SQNS Fog REgOMMENDATION Introduction As directed in the Board Carder of July 8, 1997, an interdepartmental work group was established to initiate the process required to develop a plan and identify funding to cover the costs of operating an IHSS Public Authority. The work group has reached a consensus regarding the operating model of IHSS Public Authority that could be established in Contra Costa County and has developed a draft budget for this Public Authority identifying both start-up and ongoing costs. Based upon the most recent information received from the California Department of Social Services, we are providing our best estimate of County costs for operation of the proposed Public Authority. Also, we have responded to the four critical issues identified in the July 8, 1997Board Order regarding 1) State funding for ongoing administrative costs; 2) ongoing State funding of enrage and benefit increases resulting from collective bargaining; 3) clarification of programmatic and fiscal claiming rules; and 4) identifying the impacts of Welfare Reform. On January 15, 1958, Social Service staff and County Counsel staff met with representatives of the IHSS Task Force to review the draft organizational and budget recommendations presented below and to receive their comments regarding these recommendations. We have indicated for your consideration where the public comments and recommendations differed from those of County staff. FIMUiUSOFDEPARTMENTS cmnly Establishment of a Public Authority requires adoption of an ordinance. Attached is our recommended ordinance. (See Exhibit 1) It is recommended that the Board of Supervisors retain control of the Public Authority by establishing itself as the governing body of the Authority rather than creating a separate and independent governmental organition. .Pour primary reasons for organizing the Public Authority under the Board of Supervisors are as follows: 1. The funding and management of IHSS providers will continue as a practical neer to be a County responsibility incollaboration with the State. 2. The County Social Service Department will continue}to have legal responsibility for gement of the IMS pro and must be able link its activities directly with those of the Authority. 3. As the Public Authority will be able to enter into wage and benefit agreements with labor unions representing IHSS providers for which County funds will be obligated, the Board of Supervisors should retain direct governing control. 4. The creation of a separate governmental agency would entail significant extra costs for governance and agency operations. Risk Mmag==1 If an IHSS Public Authority is established, insurance must be purchased to protect the County and Public Authority from any workers' compensation or liability exposures. Recommended coverages are workerscompensation insurance for authority staff and at least $5 million in general liability insurance. The liability insurance should cover personal injury, property damage, public officials' errors and omissions, automobile liability and contractual liability exposures. Alternatives to the purchase of insurance for the workers' compensation and liability exposures are to be uninsured or to be covered under the County's self- insurance programs. These are not prudent or viable alternatives. The Authority must have insurance protection against losses, and the County might be a "deep pocket" for any losses incurred by the Authority. To cover the Authority under the i County's self-insurance program places the County and County dollars at risk. It is preferable that the risk transfer of the Public Authority's exposure be made to insurance policies. Humin_ Re ourc�es --- Staff prepared a comparative analysis of the staffing and personnel structure and of the labor relations status of the IHSS Public Authorities in Alameda, San Mateo, and Santa Clara Counties for review by the interdepartmental work.group. (See Exhibit 2.) The human resources support required for the IRSS Public Authority is almost exclusively in the labor relations area. There needs to be an employer relations policy negotiated and drafted, an election conducted to select employee representatives for IHSS providers, an initial contract negotiated, and participation in ongoing labor relations activities. There is no need for human resources support in employment programs as that will be handled by the registry or by the IHSS clients and providers themselves. The options for providing the labor relations support for the Public Authority are as follows: 1) County Human Resources Department administer labor relations for the Public Authority with the support of industrial.Employers and Distributors Association(IEDA),the County's designated contractor for labor relations. 2) as proposed by members of the public at the January 15, 1998 meeting with the IHSS Task Force, IEDA would be responsible to the Public Authority Executive Director for labor relation activities. We recommend option##1 as the labor relation activities of the Public Authority need to be closely coordinated with overall County labor relations and collective bargaining policies to avoid possible conflicts of interest. 2 r SQcia crvice Qe-p ent FiNal Claiming Prtor' Social Service staff have met with California Stare Department of Social Services Staff'to review the proposed fiscal claiming procedures and regulations for IHSS Public Authorities and have thoroughly analyzed those regulations and draft claiming procedures. Under the neve fiscal.claiming procedure outlined in the draft All County :better released by the California Department of Social Services in October19971 there is a very complex methodology established for determining the respective Federal, State, and County share of Public Authority operating expenses. Under this methodology,Public Authority admini within our annual funding allocation: Federal 34.8% State 42.3% County 22.9% Applying the draft Public Authority claiming procedures under the best case scenario, assuming the maximum possible State funds are available in the County's IHSS services allocation,the County would be responsible for approximately 22.9% of the Public Authority operating budget. However,the availability of State funds willl be contingent upon the annual appropriation of funds in the State Budget and upon the number of IHSS service hours actually delivered to clients,which is based upon the assessed hours of service awarded to clients by social work staff. If the State fads to appropriate and allocate sufficient funds to meet both the usage of IHSS provider hours and Public Authority administrative costs, the County would be liable for any shortfall of funds. At the January 15, 1998 meeting with the IHSS Task Force, a spokesman for SEI/Local #250 reiterated their position that the language in AB 67 (Chapter 606, Statutes of 1997)requires that the California Department of Social Services (CDSS) include in its budget sufficient State funds to provide the State share of Public Authority operating costs. However,in conversations with CDSS staff County staff have been informed that no new State funds are available to cover the State share of Public Authority operating costs. Instead, we have been informed that the State share of public Authority operating expenses must come from within the existing IHSS services allocation for our County. No new State funds will be made available to us unless and until they are appropriated within the State Budget at some future time. Attached as Exhibit 3 is a copy of a letter to CDSS attempting to obtain clarification of this issue. Under the worst case scenario, assuming there would be no State funds available in the annual services allocation because of high demand for IHSS provider services and/or insufficient State Budget appropriations, the County would be liable for both the State and County share or 65.2%of Public Authority a ............... ............................................ .............................................. ............................................... ............................................... . . . . ............. ...................................... ....................................... _........... ....................................... ......................................................................._____.. ..................................................... .................. .........................................................................____. ................................................................. .. administrative costs. The balance would be covered by Federal funds. 1=act of WA&=Rd= At this time, we can report that the implementation of Welfare Reform.in California would appear to have a minimal impact upon the IHSS program and the potential establishment of Public Authority in the county. 'There has been no shift of overhead costs from ether social service programa to the KISS prom as we had earlier feared. 'Thus, there is no fiscal impact from Welfare Reform that affects Public Authority implementation. Also, the maintenance of SSI benefits for non-chin residents has prevented any significant reduction in IHSS client population as anticipated.earlier.. We continue to experience gradual caseload growth in the HISS program. Also, there has been no change in the level of State support for the IHSS program despite the reduction in Title XX Block Grant funding included in the original Welfare Reform legislation.. Unknown at this time is the fi ature impact of the new work requirements in the TANF program on increasing the pool of potential IHSS provides Our registry contractor, St. Vincent de Paul, is attempting to target TANF recipients in their recruitment of potential IHSS providers. In 1998 we hope to explore the possibility of developing taninitig resources under TANF for potential IHSS providers. As approved by the Hoard.of Supervisors, the Social. Service Department has moved forward with the development of registry and provider support services to address the need for matching skilled providers with IHSS clients. St. Vincent de Paul was selected as operator of our contact registry service. Since beginning operations in September, 1997, the registry has interviewed 176 potential providers. 133 individuals are currently actively registered. 145 IHSS clients have requested assistance from the registry since September. Of that number, 40 were successfully matched with a provider; 41 clients found their own provider; and 60 clients are currently are in the process of being assisted; and 4 clients withdrew their requests due to changes in circumstances. 5 Also, since September, 1997, our provider support program assistant has helped 77 clients who have difficulty managing provider-related issues on their own. This important program enhancement assists those IHSS recipients who need the intervention of third party assistance to deal with providers. During these initial three months of operation of both the registry and provider support programs it has become evident that the demand for these services greatly exceeds the limited capacity of these pilot efforts. During the coming months we hope to identify additional resources to be able to expand the capacity of both of these new program elements to respond more effectively and promptly to the requests for help from both clients and providers. ( R9ANIZAnQhTAT STRtTCTt1RF When an KISS Public Authority is established in Contra Costa County, we recommend it be set up as a public entity separate from the County government but with the Board of Supervisors as its governing body similar to the relationship that exists with the Housing Authority. The Public Authority would enter into an interagency agreement with the County Social. Service Department for reimbursement of its costs and expenses as the Social Service Department will retain its responsibility for overall management of the IHSS program.. Employees of the Public Authority should not be employees of Contra Costa County for any purpose. We recommend that the Public Authority establish its own employee classifications parallel to comparable County classifications. From our review of the existing public authorities in other counties, we have identified the need for the following three staff'positions: 1)Executive Director(comparable to Social Service Division Manager), who would be responsible for overall management and policy direction for the Public Authority in cooperation with the advisory body; would serve as liaison to the Board of Supervisors, County Administrator, Social Service Department, Human Resources Department, IEDA, and County Counsel, and would serve as principal staff support for the advisory body. 6 1111...................... ..................................................................... ........................................................................................_ ......... ......... ......... ......... ................. ........ ......... .. ...................... ...................... ........ ......... ......... . ... ....................... ......... ......... ......................................... ..............................................................1.111...................... 2) Program Manager(comparable to Administrative Services Asst. III), who would be responsible for day-today implementation of registry and provider training activities either through supervision of subordinate staff or monitoring of contracted activities; and would provide staff support to committees'of the advisory body. 3) Office Merger/Secretary(parable to Clerk Spec ahst/Lead Level), who would oven daily o ce.operations and provide clerical support to staff and advisory council members and committees. The Public Authority should have the authority to provide assistance to IHSS recipients in girding providers through establishment of a registry. We recommend that the Board of Supervisors grant the Public Authority the power to provide registry services either directly itself with its oven employees or by contract with another agency pursuant to the Welfare and Institutions Code. This registry would be required to investigate the qualifications and background of potential IHSS providers and would establish a referral system.for lhiking potential providers with.IHSS recipients. The registry would have the authority to provide for training for providers and recipients. The Public Authority should be deemed to be the employer of IHSS providers for the purposes of collective bargaining, but KISS recipients should retain the right to select, terminate, and direct the world of IRSS providers providing services to them. We recommend that IEDA be retained by the Human Resources Department to administer the labor relations activities of the Public Authority in concert with the overall labor relations and collective bargaining policies of the Berard of Supervisors. EEDA would be responsible for negotiating and drafting an employee relations policy, conducting an election to select employee representatives, negotiating an initial contract and participating in ongoing labor relations activities. Also, the .Board of Supervisors, acting as Board of Public Authority, should, appoint eleven members to a Public Authority advisory committee at least 50% of whose members are current or past users of personal assistance services. The Public Authority staff members would provide staff support to his advisory body. 7 Attached as Exhibit 4 is an organizational chart depicting the interrelationships between the various County agencies and entities that will need to work together to implement the responsibilities of the IHSS Public Authority. Listed below are the major roles and responsibilities of each: Board of Suserviso�r. governing body of the public Authority oversees Public Authority operations appoints I I Advisory Committee members hires and supervises Public Authority Executive Director with advice of Advisory Committee adopts employer-employee relations policy for Public Authority appropriates the County general fund dollars for the County share of Public Authority king, consistent with enabling ordinance ratifies Public Authority collective bargaining agreements Public Authority Staff responsible for either day-today operation of registry or oversees operations of registry contractor conducts labor representation election for IHSS providers with assistance from IEDA as necessary conducts collective bargaining regarding provider wages and benefits with assistance from IEDA provides information on available training for IHSS providers and recipients 8 b blit Anjority Advisor (committee provides advice to Board of Supervisors and Public Authority staff regarding Public Authority f motions Q ce of ft.0t , r Admini facilitates communication between bogs Public Authority staff and.Advisory Committee and the Board of Supervisors Rid" mol arranges for necessary liability insurance coverage for Public Authority Ste.' wc " , mcnt responsible to + :alifcrnrua Department of Social Services dor day-to-day operation of IRSS program including determination of client eligibility and assessment of client need; authorizing monthly hoursof care; enrolling independent providers into automated state payroll system; and processing of IRSS provider payment claims enters into an agreement with Public Authority for reimbursement of Public Authority operating expenses submits fiscal claiming requests to State for Federal and State share of Public Authority operating expenses umEmu= Doadmol arranges for recruitment and employment of Public Authority staff consults with IEDA to assure that tabor relations activities of Public Authority are administered in conjunction with overall County labor relations policy Co Counsel drafts ordinance establishing Public Authority provides legal consultation and representation services for Public Authority 9 Attached as Exhibit 5 is a chart depicting the major initial implementation activities required to establish a working IHSS Public Authority. ES IMA_'I`M BUDGET FOR PUBLIC AMORITy A 14MISIEA ION Our interdepartmental work group has developed an annual budget for Public Authority administrative operations based upon investigation of existing public authorities and our knowledge of the costs of providing comparable services in our respective departments. We have identified both start-up costs in the initial year of operation as well as ongoing costs. We have prepared a line item annual budget for both a start-up year and ongoing year which is attached as Exhibit 6. The estimated total annual costs for the initial start-up year of Public Authority operations are$739,920. Ongoing annual costs are estimated to be $666,820. The major additional expenses anticipated during the start-up year include labor relations services involving drafting of an employee relations policy, conducting a representation election, and initial contract negotiations; legal services involving drafting and enactment of an enabling ordinance and creation of a new labor relations system; and purchase of office fin-niture, computers, and computer programming services. In the January 15, 1998 meeting with the IHSS Task Force, County staff' received a variety of recommendations suggesting revisions in the attached draft line item budget. Those comments are summarized below for your consideration: 1) Public Authority staff salaries and benefits indicated are excessive; lower paid job classes should be used 2) Funding indicated for registry operations is insufficient for staffing required and does not take into account the possibility of the registry being directly operated by the Public Authority instead of through a contract agency 3) Labor relations costs for both IEDA contract and Human Resources staff'liaison are excessive and should be reduced 10 4) The scope and extent of provider training indicated is excessive; casts should be greatly reduced or eliminated 5) Quantity and cast for legal services is excessive and should be greatly reduced 6) Social Service Department staff liaison time can be reduced 7) In-kind donation of office space should be sought to reduce costa g) Two computers rather than three should be adequate for the staff 9) Advisory Committee expenses allotment should be increased to cover the costs of transportation, translation, attendant care, and other special sees needed by disabled members of the committee 10) Printing and postage costs are excessive and should be greatly reduced 11) Five telephone lines rather than ten would be adequate There is also a potentially significant additional expense whose amount is unknown at this time and which we were unable to include in Exlu'bit 5. The California Department of Social Services has informed us that if the County establishes a Public Authority, County funds will be required to cover our share of increased costs to the state IHSS payroll system attributable to public authorities. The public authority counties will be responsible for their proportionate share of these costs. Preliminary discussions with State staff indicated that the total statewide costs could be as much as $1 million. EMS T P�blic Audwdly Qpzuling Cots- 1) Federal Funding Availability As noted earlier, as the Federal share of Public Authority operating costs comes from open-ended Medicaid entitlement funds, we are essentially guaranteed that Federal funds will be available every year to cover approximately 34.8% of Public Authority operating expenses. Only when the total combined hourly rate for provider costs and Public Authority operating costs exceeds 200% of minimum wage will this Federal contribution be capped. As the estimated ongoing costs of the Public Authority will add only approximately $.13 per hour cost or only 2.3%of minimum wage to provider wages and fringe benefits, the 200%limitation will not be reached unless very significant wage and fringe benefit increases are negotiated by the Public Authority. Thus,this 200%limitation is not likely to become a reality in the immediate future. However, there have been recent Congressional proposals to convert Medicaid from an open- ended entitlement program to an annual closed-end appropriation,which, if ever enacted, would decrease this guaranteed level of Federal participation in IHSS program costs. 2) State Funding Availability As noted earlier,the State share of Public Authority operating costs will come from our annual closed-end allocation of IHSS services funds as appropriated in the adopted State budget. During the current fiscal year, we have been allocated sufficient State funds, given our current expenditure rate for provider payroll costs, to assure the maximum.42.3% State participation in the operating costs of the Public Authority. To be assured this level of maximum participation in the future requires that the annual allocation of State funds to the County covers both our increased caseload growth and future minimum wage increases to providers. If future State appropriations are not commensurate with future caseload growth and/or minimum wage increases, then the State share of Public Authority operating expenses may fall below this maximum. 12 3) Estimated County Costs Applying the draft Public Authority claiming procedures under the best case scenario, assuming the maximum possible Mate funds being available in the county's IRSS services allocation, the County would be responsible for approximately 22.9%of the Public Authority operating budget or approximately $169,400 in the start-up year or$152,700 annually on an ongoing basis. Under the worst case scenano there would be no State funds available in the annual IHSS services allocation because of high demand for IHSS provider services anchor insufficient "tate Budget appropriations. In this instance,the County would be Babble for both the State and County share or 65.2%of Public Authority administrative costs. The balance would be covered by Federal funds. In this case, the total annual cast to the County would be approximately$482,400 during the start—up year and$434,800 on an ongoing basis. "mus, the annual financial cost to the County for Public Authority adatrative expenses could range between $152,700 and $434,800 depending upon the availability of State funds in any given year. Also, there will be the unknown additional costs of modifications to the statewide HiSS payroll system that must be paid for by the Public Authority counties. As indicated above, the promulgated State regulations and draft fiscal claiming methodology have made no change in the fact that the State:will not participate financially in any wage or benefit increases resulting from Public Authority negotiations with IHSS provider representatives. This assignment of fiscal responsibility to the County for the results of collective bargaining in effect creates an unfunded mandate for the County once the County establishes a Public Authority. Until the State adopts legislation and budget appropriations providing for State participation in the results of.Public Authority collective bargaining, the 13 County would be liable for bath the State and County share or approximately 65.2% of any wage and benefit increases. Given our current number of annual hours of service and current mix of cases eligible for partial Federal reimbursement of any negotiated wage and benefit increases, every$.50 per hour increase in wages and benefits negotiated by the Public Authority would cost the County an additional $1.5 million annually. (Due to caseload changes this is a slightly lower figure than the $1.6 million estimated in the Apr L 1997 report to the Board.) As you know, SEItJ is actively supporting a legislative remedy to the above situation which would provide for State participation in such negotiated increases. However, it is our understanding that the proposed legislation would simply amend the Welfare and Institutions code to permit State financial participation in Public Authority costs including negotiated wage and benefit increases. Without appropriation of additional State Bands to the counties for this purpose, the County would be liable to spend County funds to cover all or much of the State share of any .negotiated wage and benefit increases. Thus,from a fiscal perrsp6ctive, by proceeding with implementation of a Public Authority,the County does take on substantial financial risk until there is a guarantee of ongoing State appropriations to meet these negotiated wage and benefit increases as well as the anticipated growth in the IHSS client population resulting from the aging of the population. Also, it should be noted that even if there is maximum state participation in these wage and benefit increases,the County shame of any such increases would stiff be approximately 22.9°!x, a not inconsiderable, if smaller, amount of money. The ,annual cost to the County at this lower sharing ratio would be approximately $519,040 for a $.50 per hour increase to IHSS providers. SQ=es for CMMtYRtYe2I= In order to finance the County share of Public Authority operating costs and of any future wage and benefit increases for KISS providers negotiated by the Public Authority, the .Board of Supervisors will need to consider the various options listed below: 1) currently available County general funds 2) reductions in other general fund supported programs and activities 14 3) new outside revenue such as foundation grants or special project funds 4) approximately $15,000 in County funds in current Social Service Department budget supporting the IHSS registry contract 5) support for State legislation providing additional funds to counties for IRSS Public Authorities. 15 Cd bb C�1 3 �s 151 cd c 0 _ = s _ _ x x _ _ _ _ s x s 0 x s CL CL N d eot LZ '72 a 0 r13 a. 00 EL x • • x _ _ cy b Exhibit 5 W Ul LL 0 � U ' £ cr- 0 0 Z a � z� W z 0 c- 0 � � d 0 � w < z z '-j w m w ¢ ui 0. 0 w a. 0 Z M cn t� CL w U- (9a. 5 h w > 0 W Z n zz cr- z 0- w2 w LL wQ z - 0 { C� w CD m CL ca .1 M w c a. w or z w > M Q CL D CL CL U 0 U- 0 0 I CDw w Proposed Exhibit 6 Public Authority Annual Budget Start-up Year Ongoing Salaries/Benefits Exec Director 5100/mo 61,200 61,200 Prog Manager 41501mo 49,800 40,800 Office Mgr/Clerk 3000/mo 36,0Ci0 36,000 Fringe Benefits @ 27% 42,630 42,630 189,630 189,630 Registry Operations Coordinator, clerk, three regional aides and 125,000 125,000 office support Labor Relations Services Contract with IEDA Initial Employee organization recognition 45,000 and negotiation Ongoing Labor relations services 25,000 t Human Resources Staff Liaison 35,000 35,000 80,0030 60,000 Liability and Workers 20,000 20,000 Compensation insurance Provider Training Train 900 providers per year(75 per month)for 45,000 45,000 $50 per session Provide $25 training stipend per session to 22,500 22,500 providers (900 x$25) 67,500 67,900 Legal Services 12603 hrs/yr @ 86.501hr 109,000 1000 hrs/yr @ 86.50/hr 86,500 109,000 86,500 MOMMANNEM WAIMM I'llill IN 1111 OWN 11,11 liiiiiiiiiiii III I` Social Service Department 50% Staff Asst. 11 $27151mo wages &fringes 32,580 32,580 Staff Liaison - Office Space 1200 sq ft @ $1.50/sq ft/month 21,600 21,600 Office Furniture Desks, chairs, workstations, files & bookcases 5,000 for 3 staff 15 tables and 30 chairs for conference room 9,000 Audio-visual equipment 500 14,500 ,.Computer Hardware & $4000 @ for 3 staff 12,000 Software Acr- 'ting/Auditing Annual Accounting costs 4,000 4,0100 C` _ds Annual Audit costs 6,000 4,000 10,000 Public Authority/BUDGETWALS exhibit 6 (Cont`d) Advisory Committee Mileage reimbursement averaging $30 per 3,900 3,900 Expenses month for 11 members Stationery 600 600 Meeting refreshments & supplies for 1,200 1,200 $100/month 5,700 5,700 Office Supplies $2000 initial purchase of stationery, desk 2,000 supplies, etc. Monthly replenishment of office supplies 1,650 1,800 8,650 1,800 Postage Monthly mailings to 5,000 providers ($900) 12,000 12,000 Other monthly postage($100) Printing Informational fliers 6,000 6,000 Training manuals- 1,000 per year for providers NO 10 Books, periodicals 500 500 Office Equipment FAX purchase& installation 1,000 Photocopy rental($5301month) 6,360 6,360 7,360 61360 Telephone 10 telephone lime installation 1,000 10 telephones @$50/month 6,000 6,000 7,000 6,000 RONNIE 01 Staff mileage $100 @ for two staff per month 2,400 2,400 Staff and Advisory Council Four attendees at conferences @$500 2,000 2,000 Travel/Conferences Staff Training Four group Facilitation Training sessions for 2,000 staff and Advisory Council @$500 Semi-Annual group facilitation training for staff 1,000 and Advisory Council 2,000 1,000 IT/Programming Expenses 60 hours @ $75/hr 4,500 30 hours @ 75/hr 2,250 4,500 2,250 70t"herProfessional Services Consultants for needs assessment, program evaluation, event pians, etc. i 1130 hrs $60/hr 6,000 50 hrs $60/hr 3,000 6,000 3,000 1 =, neous expenses 5,013(7 5,17413 TOI-AL 739,920 666,820 Public Authority/BUDGET97ALS APPENDIX G COUNTY ORDINANCE NO.98-14 IN-HOME SUPPORTIVE SERVICES AUTHORITY ORDINANCE NO. 98-14 In-Herne Supportive Services Authority The Contra.Costa County Board of Supervisors ordains as follows(omitting the parenthetical footnotes from the official text of the enacted or amended provisions of the Ordinance Code): SECTION I: Division 55 is added to the Contra Costa County Ordinance Code to read: DIVISION 55 In-Home Supportive Services Authority Chapter 55-2 Authority Established Article 55-2.2 General 55-2.200 D- fines loons. 1. "IHSS"means in-home supportive services as described in Welfare and Institutions Code section 12300 (a), (b), et seq. 2. "Provider"means a person who provides in-home supportive services to a recipient. 3. "Recipient"means a person eligible and authorized to receive in-home supportive services under Welfare and Institutions Code section 12300, et seq. 4. "County"means Contra Costa.County. (Ord. 98-14) 55-2.202 u hori y`r j . Pursuant to Welfare and Institutions Cade section 12301.6 the Centra Costa County Board of Supervisors establishes a public authority to provide for the delivery of in-home supportive services. (Ord. 98-14) ORDINANCE 98-14 1 55-2.204 Name- The name of the authority shall be the Contra Costa County In- Home Supportive Services Authority. (Ord. 98-14) 55-2.246 Qoveming Body. 'The governing body of the Contra Costa County in- Home Supportive Services Authority is the Contra Costa County Board of Supervisors, (Ord. 98-14) 55-2,208 SM=e E ttty. The Contra Costa County In-Home Supportive Services Authority shall be a public entity separate from the County of Contra Costa and shall file the statements required by Government Code section 53051. (Ord. 98-14) 55-2.210 Advisory `'o=jttee, The Board of Supervisors shall appoint an advisory committee to the Contra.Costa County In-Home Supportive Services Authority. Such advisory committee shall consist of eleven individuals,provided that no fewer than 50 percent of the members of the advisory committee shall be individuals who are current or past users of personal assistance services paid for through public or private funds or recipients of services under Article 7 of fart 3 of Division 9 of the Welfare and Institutions Code. (Ord. 98-14) Article 55-2.4 Authority Powers 55-2,442larcter pf Authority The Contra Costa County In-Home Supportive Services Authority shall be a corporate public body,exercising public and essential governmental functions,that has all the powers necessary or convenient to carry out the delivery of in-home supportive services in Contra Costa County,including the power to contract for services pursuant to sections 12302 and 12342.1 of the Welfare and Institutions Code, and to make or provide for direct payment to a provider chosen by the recipient for the purchase of services pursuant to sections 12302 and 12302.2 of the Welfare and Institutions Code. (Ord. 98-14) 55-2.404 Autholily Employ=. Employees of the Contra Costa County In-Home Supportive Services Authority shall not be employees of Contra Costa County for any purpose. (Ord. 98-14) 55-2.406 Authority Functions. The Contra Costa County In-Home Supportive Services Authority shall carry out the following functions: 1. The provision of assistance to recipients in finding in-home supportive services personnel through the establishment of a registry. ORDINANCE 98-14 2 2. Investigation of the qualifications and background of potential in-borne supportive services personnel. 3. Establishment of a referral system under which in-home supportive services personnel shall be referred to recipients. 4. Providing for training for providers and recipients. However,the Authority shall not be obligated to provide training directly,to pay for training provided privately or in the community,to pay providers for the time spent in training,to accompany recipients to training, to pay for transportation to training,or to pay for any materials required by the training. The Authority is not obligated to screen or be responsible for the content of any training it informs providers or recipients is available in the community. The Authority is not obligated to ensure that any provider or recipient attend or complete any training. 5. Performing other functions related to the delivery of in-home supportive services as directed by the Board of Supervisors. 6. Ensuring that the requirements of the personal care option pursuant to Subchapter 19 (commencing with Section 1396)of Chapter 7 of Title 42 of the United States Code are met. (Ord. 98-14) 55-2.408. Seryi*cg Providermploentc Aigns. The Contra Costa County in- Home Supportive Services Authority shall be deemed to be the employer of in-home supportive services personnel referred to recipients as provided in part 3 of section 55-2.406,within the meaning of Chapter 10(commencing with section 3500)of Division 4 of Title 1 of the Government Code,provided,nevertheless, that recipients shall retain the right to select, terminate, and direct the work of any in-home supportive services personnel providing services to them. In order to assure the preservation of the individual provider mode and lirnit the liability of the Authority,the Authority shall have no authority or jurisdiction to regulate,control, or limit the rights and responsibilities of recipients of in-home supportive services to hire, fire or supervise providers. The right to supervise includes,but is not limited to,the right to determine matters such as work schedules,tasks and duties,assignments and direction of work„ methods and standards of care and conduct, discipline,provisions for safety and security, control of premises,any inn-Dome living or other accommodations, and final resolution of concerns, problems and complaints relating to such supervision. Recipients retain such rights and responsibilities independent of the Authority, just as they held such rights and responsibilities independent of the county prior to the formation of the Authority. (Ord. 98-14) ORDINANCE 98.14 3 55-2.410 Recipient Selection. Recipients of in-home supportive services may select in-home supportive services personnel who are not referred to them by the Contra Costa County In-Home Service Authority. Those personnel shall nevertheless be referred to the Authority for the purposes of wages, benefits, and other terms and conditions of employment. (Ord. 98-14) 55-2.412 Statenonsibi hies. The creation and operation of the Contra Costa County In-Home Supportive Services Authority shall not alter,require the alteration of,or interfere with the state payroll system and other provisions of Welfare and Institutions Code section 12302.2 for individual providers of in-home supportive services,or affect the state's responsibility with respect to unemployment insurance or worker's compensation for providers of in-home supportive services. (Ord. 98-14) Article 55-2.6 Authority Administration 55-2.602. Authority Director. The director of the Contra Costa County In-Home Supportive Services Authority shall be appointed by the Board of Supervisors. (Ord. 98-14) 55-2.604. ,tabor Relations. The Contra Costa County Employer-Employee Relations Resolution(Board of Supervisors' Resolution No. 81/1165), or any succeeding such resolution, shall be applicable respecting the labor relations responsibilities of the Contra Costa County In-Home Supportive Services Authority,provides,nevertheless: 1. A showing of interest of at least ten percent(10%) of the eligible providers, as defined by the Authority, shall be a sufficient showing of interest for any labor organizations to initiate any election or representation procedures established by the Authority for the purposes of certifying an exclusive representative for purposes of collective bargaining; 2. The Authority shall have a non-strike clause in any and all collective bargaining agreements with providers and personnel of the Authority. The non-strike clause shall continue at least one year beyond the other provisions of any and all collective bargaining agreements. 3. Any collective bargaining agreement reached between the Authority and any labor organization certified to represent providers shall be subject to the limitations of this chapter and to ratification in its entirety(i.e. all provisions of such agreements shall be subject to the same vote)by a simple majority of votes cast in a ballot in which all eligible providers, as defined by the Authority, shall be qualified to participate. Final adoption of any such agreement shall be by simple majority of the Board of Supervisors. ORDINANCE 98-14 4 _......................................................................... .................................................................................................................. _.............................................._......................................................................................._ _ .... ......... .......... ........ ......... ........ ........... ....... ......... ......... ............... .._ ........_ ......... ... .... .. ....... ......... 4. The county Duman Resources Department is designate as manager of labor relations for the Authority. (Ord. 98-14) 55-2.606 County Cly off. The costs and expenses of Contra.Costa County to provide administrative,legal, labor relations, and other services to the Contra Costa County In-Home Supportive Services Authority,and to make payments to or provide benefits for in-home supportive services providers,shall be charged against the funds of the Authority. (©rd. 98-14) 55-2.648 Fiscal Provisions. 1. The establishment and operation of the Authority or application of Government Code section 3540,et seq., shall not result in payments from the county's general fund beyond the county' s annual appropriation for the Authority, if any,which shall be an absolute limit on county cost. 2. The total of all operating costs, wages, and benefits proposed or established by the Authority shall be consistent with the provisions of the county budget. The Authority shall not establish a payment rate, including costs of wages,benefits and operation, until the Authority determines that the funds necessary for the payment rate are legally available. The annual appropriation for the Authority,if any,contained in the county's fiscal budget for any fiscal year shall be an absolute limit on county cost for that fiscal year. 3. The Authority shall adopt its budget under the same laws,rules and policies that control the county budget process. 4. The Authority shall not have the authority to agree to or approve any collective bargaining or other agreement that requires an increase in wages or benefits unless there is a state or federal match for such increases. Services shall not he reduced in order to fund the Authority or implementation of Government Code section 3540, et seq. 5. The maximum amount of county funds available in any given budget year for the wage and benefit negotiations, if any, shall be set by the Board of Supervisors as part of the county's annual budget. While the establishment of this figure shall not obligate the county, it shall serve as the absolute limit to county costs for any increases negotiated in collective bargaining taping place that fiscal year. The absolute cap on annual county spending on wage or benefits increases shall not be affected by any potential changes in state or federal reimbursement rates. (Ord. 98-14) ORDMANCE 98-14 5 Article 55-2.8 County and Authority Liability 55-2.802 No Employer Liability, The Contra Costa County In-Horne Services Authority shall be deemed not to be the employer of in-home supportive services personnel referred to recipients under this ordinance for purposes of liability due to the negligence or intentional torts ofthe in-home supportive services personnel. (Ord. 98-14) 55-2.804 No Mon.-referral LiabiWtY. The Contra Costa County In-Horne Services Authority shall not be held liable for any action or omission of any in-home supportive services personnel whom the Authority did not list on a registry or otherwise refer to a recipient. (Ord. 98-14) 55-2.846 No Co`tY ly LiabiliM The County of Contra.Costa and the State of California shall be immune from any liability resulting from the implementation of Welfare and Institutions Code section 12301.6. (Ord. 98-14) 55-2.408eenn y mobility. 1. Any obligation of the Contra Costa County In-Home Services Authority,whether statutory,contractual,or otherwise,shall be the obligation solely of the Authority and shall not be the obligation of the County of Contra Costa or the State of California. 2. The Authority shall not be held liable for any act or omission of any provider whom the Authority did not list on its registry or otherwise refer to a recipient. 3. The county shall be immune from any liability resulting from its implementation of this chapter and/or administration of the IHSS program pursuant to Welfare and Institutions Code section 12301.6. 4. Any and all contracts, leases,or other agreements of any nature, including collective bargaining agreements,between the Authority and third parties other than the county shall contain an express provision advising the third party that the Authority is a separate governmental entity and that such agreement does not bind Contra Costa County. 5. The Authority shall require any and all third parties contracting with the Authority to indemnify and hold harmless the Authority,to provide the Authority with written acknowledgment of such indemnification, and to maintain adequate levels of insurance, as determined by the County's risk manager,naming the Authority as an additional insured. (Ord. 98-14) ORDINANCE 98-14 6 55-2.810 Liability insurance. Without limiting its indemnification of the county as set forth below, the Authority shall acquire and maintain appropriate insurance in amounts and coverage types to be determined by the county's risk manager to be adequate, and shall name the county and the members of the Board of Supervisors as additional insureds on any policies of insurance maintained by the Authority. Evidence of such insurance shall be provided to the county's risk manager within thirty days of procurement. (Ord. 98-14) 55-2.812 Indemnification. The Authority shall indemnify,defend and hold harmless the county and its special districts,elected and appointed officers,employees and agents from and against any and all liability, including defense costs and legal fees, and claims for damages of any nature whatsoever, including but not limited to personal injury or property damages, arising from or connected with any act or omission of any officer or employee of the Authority. (Ord. 98-14) Article 55-2.10 Non-Severability 55-2.1002. 1. If any section of this chapter, or the application of such section to any person or circumstance, is held invalid, each and every of said provisions of this chapter shall not be deemed severable from the provisions of this ordinance establishing the Authority, and this chapter shall be held invalid in its entirety. 2. If this chapter becomes invalid under with subsection(1) above, the Authority created by this chapter shall cease to exist,and the county shall immediately resume the provision of IHSS as were provided prior to the adoption of this ordinance. (Ord. 98 - 14) Article 55-2.12 Termination 55-2.1202. By repeal of this Division,the Board of Supervisors may terminate the Contra Costa County In-Home Services Authority. (Ord. 98-14) 55-2.1204. Unless extended by ordinance of the Board of Supervisors, this Division 55 (Chapter 55-2) shall be repealed in its entirety on March 1,2001 (and be of no further force and effect on that date), and the county shall immediately resume the provision of IHSS as were provided prior to the adoption of this ordinance. (Ord. 98 - 14) ORDINANCE 98-14 7 SECTION 11: EFFECTIVE D TE. This ordinance becomes effective 30 days after passage, and within 15 days after passage shall be published once with the names of the Supervisors voting for and against it in the CONTRA COSTA TIMES,a newspaper published in the County. PASSED on March 17, 1998 , by the following vote: AYES: Supervisors Gerber, LeSaulnier, Canciamiila, Rogers NOES: Supervisor Uilkema ABSENT: hone ABSTAIN: hone ATTESTED: PHIL BATCHELOR., Clerk of the Board of Supervisors and County Administrator Deputy Shirley Casillas Board thair Jim Rogers [SEAL] HAGR0UPSWAFFIIHSS-0R2.wPD ORDINANCE 98-14 8 .......................................................................................................................................................................................................................................................................................................................... ......... .......... . .......................... ............... .............. ..... ............. . ....... . . ..................... .....................................-......................................................._....... ......... ......... _ _ _ __ ___ _ _ __ __ APPENDIX R WELFARE and INSTITUTIONS CODE 12301.6 WELFARE and INSTITUTION CODE 12301.6 12301.6. (a)Notwithstanding Sections 12302 and 12302.1,a county board of supervisors may,at its option,elect to do either of the fallowing: (1)Contract with a nonprofit consortium to provide for the delivery of in-home supportive services. (2)Establish,by ordinance,a public authority to provide for the delivery of in-home supportive services. (b)(1)To the extent that a county elects to establish a public authority pursuant to paragraph(2)of subdivision(a),the enabling ordinance shall specify the membership of the governing body of the public authority,the qualifications for individual members,the manner of appointment,selection,or removal of members,how long they shall serve,and other matters as the board of supervisors deems necessary for the operation of the public authority. (2)A public authority established pursuant to paragraph(2)of subdivision(a)shall be both of the following: (A)An entity separate from the county,and shall be required to file the statement required by Section 53051 of the Government Code. (B)A corporate public body,exercising public and essential governmental functions and that has all powers necessary or convenient to carry out the delivery of in-home supportive services,including the power to contract for services pursuant to Sections 12302 and 12302.1 and that makes or provides for direct payment to a provider chosen by the recipient for the purchase of services pursuant to Sections 12302 and 1230.2.2. Employees of the public authority shall not be employees of the county for any purpose. (3)(A)As an alternative,the enabling ordinance may designate the board of supervisors as the governing body of the public authority. (B)Any enabling ordinance that designates the board of supervisors as the governing body of the public authority shall also specify that no fewer than 50 percent of the membership of the advisory committee shall be individuals who are current or past users of personal assistance services paid for through public or private funds or recipients of services under this article. (C)If the enabling ordinance designates the board of supervisors as the governing body of the public authority,it shall also require the appointment of an advisory committee of not more than I I individuals who shall be designated in accordance with subparagraph(B). (D)Prior to making designations of committee members pursuant to subparagraph(C),or governing body members in accordance with paragraph(4),the board of supervisors shall solicit recommendations of qualified members of either the governing body of the public authority or of any advisory committee through a fair and open process that includes the provision of reasonable,written notice to,and a reasonable response time by,members of the general public and interested persons and organizations. (4)If the enabling ordinance does not designate the board of supervisors as the governing body of the public authority,the enabling ordinance shall require the membership of the governing body to meet the requirements of subparagraph(B)of paragraph(3). (c)(1)Any public authority created pursuant to this section shall be deemed to be the employer of in- home supportive services personnel referred to recipients under paragraph(3)of subdivision(d)within the meaning of Chapter 10(commencing with Section 3500)of Division 4 of Title I of the Government Code. Recipients shall retain the right to hire,fire,and supervise the work of any in-home supportive services personnel providing services to them. (2)(A)Any nonprofit consortium contracting with a county pursuant to this section shall be deemed to be the employer of in-home supportive services personnel referred to recipients pursuant to paragraph(3)of subdivision(d)for the purposes of collective bargaining over wages,hours,and other terms and conditions of employment. (B)Recipients shall retain the right to hire, fire,and supervise the work of any in-home supportive services personnel providing services for them. (3)When any increase in provider wages or benefits is negotiated or agreed to by a public authority or nonprofit consortium under this section,then the county shall use county-only funds to fund both the county share and the state share, including employment taxes,of any increase in the cost of the program, unless otherwise provided for in the annual Budget Act or appropriated by statute. No increase in wages or benefits negotiated or agreed to pursuant to this section shall take effect unless and until,prior to its implementation,the department has obtained the approval of the State Department of Health Services for the increase pursuant to a determination that it is consistent with federal law and to ensure federal financial participation for the services under Title XIX of the federal Social Security Act. (d)A public authority established pursuant to this section or a nonprofit consortium contracting with a county pursuant to this section,when providing for the delivery of services under this article by contract in accordance with Sections 12302 and 12302.1 or by direct payment to a provider chosen by a recipient in accordance with Sections 12302 and 12302.2,shall comply with and be subject to,all statutory and regulatory provisions applicable to the respective delivery mode. (e)Any nonprofit consortium contracting with a county pursuant to this section or any public authority established pursuant to this section shall provide for all of the following functions under this article,but shall not be limited to those functions: (€)The provision of assistance to recipients in finding in-home supportive services personnel through the establishment of a registry. (2)Investigation of the qualifications and background of potential personnel. (3)Establishment of referral system under which in-home supportive services personnel shall be referred to recipients. (4)Providing for training for providers and recipients. (S)Performing any other functions related to the delivery of in-home supportive services. (6)Ensuring that the requirements of the personal care option pursuant to Subchapter 19(commencing with Section 1396)of Chapter 7 of Title 42 of the United States Code are met. (f)(1)Any nonprofit consortium contracting with a county pursuant to this section or any public authority created pursuant to this section shall be deemed not to be the employer of in-home supportive services personnel referred to recipients under this section for purposes of liability due to the negligence or intentional torts of the in-home supportive services personnel. (2)In no case shall a nonprofit consortium contracting with a county pursuant to this section or any public authority created pursuant to this section be held liable for action or omission of any in-home supportive services personnel whom the nonprofit consortium or public authority did not list on its registry or otherwise refer to a recipient. (3)Counties and the state shall be immune from any liability resulting from their implementation of this section in the administration of the In-Home Supportive Services program. Any obligation of the public authority or consortium pursuant to this section,whether statutory,contractual,or otherwise,shall be the obligation solely of the public authority or nonprofit consortium,and shall not be the obligation of the county or state. (g)Any nonprofit consortium contracting with a county pursuant to this section shall ensure that it has a governing body that complies with the requirements of subparagraph(B)of paragraph(3)of subdivision (b)or an advisory committee that complies with subparagraphs(B)and(C)of paragraph(3)of subdivision (b)• (h)Recipients of services under this section may elect in-home supportive services personnel who are not referred to them by the public authority or nonprofit consortium. Those personnel shall be referred to the public authority or nonprofit consortium for the purposes of wages,benefits,and other terms and conditions of employment. (i)Nothing in this section shall be construed to affect the state's responsibility with respect to the state payroll system,unemployment insurance,or workers'compensation and other provisions of Section 12302.2 for providers of in-home supportive services. Any county that elects to provide in-home supportive services pursuant to this section shall be responsible for any increased costs to the in-home supportive services case management, information,and payrolling system attributable to that election. The department shall collaborate with any county that elects to provide in-home supportive services pursuant to this section prior to implementing the amount of financial obligation for which the county shall be responsible. 0)To the extent permitted by federal law,personal care option funds,obtained pursuant to Subchapter 19 (commencing with Section 1396)of Chapter 7 of Title 42 of the United States Code,along with matching funds using the state and county sharing ratio established in subdivision(c)of Section 12306,or any other funds that are obtained pursuant to Subchapter 19(commencing with Section 1396)of Chapter 7 of Title 42 of the United States Code, may be used to establish and operate an entity authorized by this section. (k)Notwithstanding any other provision of law,the county, in exercising its option to establish a public authority,shall not be subject to competitive bidding requirements. However,contracts entered into by either the county,a public authority,or a nonprofit consortium pursuant to this section shall be subject to competitive bidding as otherwise required by law. (1)(1)The department may adopt regulations implementing this section as emergency regulations in accordance with Chapter 3.5(commencing with Section €1 340)of Part I of Division 3 of Title 2 of the Government Code. For the purposes of the Administrative Procedures Act,the adoption of the regulations shall be deemed an emergency and necessary for the immediate preservation of the public peace,health and safety,or general welfare. Notwithstanding Chapter 3.5(commencing with Section 11340)of Part I of Division 3 of Title 2 of the Government Code,these emergency regulations shall not be subject to the review and approval ofthe Office of Administrative Law. (2)Notwithstanding subdivision(h)of Section 11364.1 and Section 11349.6 of the Government Code, the department shall transmit these regulations directly to the Secretary of State for filing. The regulations shall become effective immediately upon filing by the Secretary of State. (3)Except as otherwise provided for by Section 10554,the Office of Administrative Law shall provide for the printing and publication of these regulations in the California Code of Regulations.Notwithstanding Chapter 3.5(commencing with Section 11340)of Part I of Division 3 of Title 2 of the Government Code, these regulations shall not be repealed by the Office of Administrative Law and shall remain in effect until revised or repeated by the department. (in)(1)In the event that a county elects to form a nonprofit consortium or public authority pursuant to subdivision(a)before the State Department of Health Services has obtained all necessary federal approvals pursuant to paragraph(3)of subdivision 0)of Section 14132.95,all of the following shall apply: (A)Subdivision(c)shall apply only to those matters that do not require federal approval. (B)The second sentence of subdivision(g)shall not be operative. (C)The nonprofit consortium or public authority shall not provide services other than those specified in paragraphs(1),(2),(3),(4),and(5)of subdivision(d). (2)Paragraph(1)shall become inoperative when the State Department of Health Services has obtained all necessary federal approvals pursuant to paragraph(3)of subdivision 0)of Section 14132.95. (n)(1)One year after the effective date of the first approval by the department granted to the first public authority,the Bureau of State Audits shall commission a study to review the performance of that public authority. (2)The study shall be submitted to the Legislature and the Governor not later than two years after the effective date of the approval specified in subdivision(a). The study shall give special attention to the health and welfare of the recipients under the public authority, including the degree to which all required services have been delivered,out-of-home placement rates,prompt response to recipient complaints,and any other issue the director deems relevant. (3)The report shall make recommendations to the Legislature and the Governor for any changes to this section that will further ensure the well-being of recipients and the most efficient delivery of required services. (o)Commencing July 1, 1997,the department shall provide annual reports to the appropriate fiscal and policy committees of the Legislature on the efficacy of the implementation of this section,and shall include an assessment of the quality of care provided pursuant to this section. 12301.7. The annual administrative cost for any public authority or nonprofit consortium created pursuant to Section 12301.6,exclusive of any increase in provider wages or benefits or employer taxes when negotiated or agreed to by the public authority or nonprofit consortium,shall be shared by the state and the counties as prescribed in Section 12306. APPENDIX I CRSS ALL COUNTY LETTER NO. 98-20 and PUBLIC AUTHORITY REGULATIONS ADVANCE COPY _ STATE; Of CALIFORNIA-HEALTH ANO WtEVARE AGENCY PETE WILSON. DEPARTMENT OF SOCIAL SERVICES : '`� 7,14 P Street., Sacramento, CA 95814 x March 17, 1998 REASON FOR.THIS TRANSMITTAL ALL COUNTY LETTER NO. 98--20 X j State Law Change [ ] Federal Law or Regulation Change TO: ALL COUNTY WELFARE DIRECTORS Court Order or Settlement IHSS PROGRAM MANAGERS Agreement [ ] Clarification Requested by One or More Counties ] Initiated by CRSS SUBJECT: PUBLIC AUTHORITY AND NONPROFIT CONSORTIUM SERVICE DELIVER'UNDER.THE IN-HOME SUPPORTIVE SERVICES.AND THE PERSONAL CARE SERVICES PROGRAMS The following is information regarding the irnplementation"of Senate Bill(SB)485 (Chapter 72.2, Statutes of 1992), SB 35(Chapter 69,Statutes of 1990; SB 1078(Chapter 1252, Statutes of 1993); and Assembly Bill(AB) 1354(Chapter .1029,Statutes of 1994). The Legislature added Section 12301.6 to the Welfare and institutions Code by Chapter 722, Statutes of 1992. Subsequent to this change,the Personal Care Services Program(PCSP)was implemented. As a consequence,modifications to the original version of Welfare and Institutions Cade Section 12301.6 were required. The modifications were accomplished through Chapters 69 and 1252, Statutes of 1993 and Chapter 1029,Statutes of 1994. SB 1780(Chapter 206, Statutes of 1996) made further modifications to Section 12301.6 by providing counties with guidelines for using a public authority or nonprofit consortium far delivery of In Home Supportive Services(IHSS). Emergency regulations implementing SB 1780 were effective on June 3, 1997. A copy of the regulations are attached. See Attachment A. This All-County Letter(ACL)outlines county activities,public authority or nonprofit consortium activities and State activities for counties opting to use a public authority or nonprofit consortium to provide services under the IHSS and PCSP. A description of the ratesetting methodology and claiming and reimbursement ins=tructions are also included. Upcoming Case Management:, Information and Payroiling Systems(CMIPS)changes are also described. ESTA13LIS-I NN- A PUBLIC AU1H0Rr1TY/NONPROFI'T CONSOR.'I`jUM A county board of supervisors may elect to establish.by ordinance.a public authority or contract with a nonprofit consortium to provide for the delivery of IHSS. A public authority is a corporate public body separate from the county that has all powers necessary to carry out the delivery of IHSS. A nonprofit consortium is an entity that has among other things a tax exempt status. The county is required to meet the following additional requirements for the public authority or nonprofit consortium: I. The ordinance for the public authority must specify the membership of the governing body,qualifications for individual members, the manner of appointment,removal of members,tenure and other matters the board of supervisors deems necessary. If the board of supervisors designates itself as the governing body of the public authority,the ordinance shall require the appointment of an advisory committee of no more than l l members. No fewer than 50 percent of the advisory committee.members shall be persons who are current or past users of personal assistance services paid for through public or private funds. If the board of supervisors does not designate itself the governing body of the public authority, it shall specify the membership of the governing body. No fewer than 50 percent of the members of the governing body shall be personas who are current or past users of personal assistance services paid for through public or private funds. 2. A county must enter into an interagency agreement with a public authority or nonprofit consortium to provide HISS services. The county must submit a copy of the agreement to the California Departnnent of Social Services along with the following information: An organization chart ofthe.public authority; Funding provisions for public authority casts,including hove the proposed rate was developed; • Public authority staffing classifications and duties;and A description of how the functional requirements will be met. i. The county or State will not be responsible for any liability or obligation of the public authority or nonprofit consortium whether statutory,contractual or otherwise. 4. Counties will be responsible for any increased costs to the C IPS attributable to the public authority or nonprofit consortium. The State will determine the amount of any increased costs and will bill an individual county for these costs. PUBLIC Ate', OJM AND-NQNPRO CONSOI2�ACTIM IMS Any public authority or nonprofit consortium willl be deemed to be the employer of IHSS personnel referred to recipients for purposes of collective bargaining. However,recipients will retain the right to hire,fire and supervise the work of any IHSS personnel providing services to them. Attachment B is a model Employer-Employee Relations Policy for Public Authorities. Public authorities and nonprofit consortiums may adopt,reject or modify the policy in part or in its entirety for purposes of collective bargaining. 2 I. A public authority or nonprofit consortium must provide for the following functions: Assistance to recipients in finding IHSS service providers through the establishment of a registry; • Investigation of the qualifications and background of potential personnel. 4 Establishment of a referral system under which IHSS personnel will be referred to recipients; Access to training for providers and recipients; Any other.functions related to the delivery of IHSS,and • Ensuring that the requirements of the PCSP are met. 2. A public authority or nonprofit consortium cannot duplicate any activities or services performed by the county. 3. A public authority or nonprofit consortium will not be the employer of IHSS personnel for purposes of liability due to the negligence or intentional torts of the IHSS services personnel. 4. The public authority or nonprofit consortium must notify the State of any increases in wages or benefits prior to implementation. STA'T'E ACI f1=S The State's responsibility for payroll,unemployment insurance,workers' compensation and other provisions remains unchanged. The State will continue the payrolling,unless a public authority or nonprofit consortium opts to do this function. FfWDING The costs of the public authority or nonprofit consortium will be funded from the county's services allocation. The costs must be reimbursed within the county's services allocation. Counties will be responsible for establishing a total public authority rate. The public authority rate should include a rate for services(wages,benefits and taxes) and a rate for administrative costs. The rate should be expressed in a cost per hour for the Individual.Provider (IP)mode. The contract mode should not include-any PA administration costs. For both PCSP and IHSS,the public authggV;Z,atjcannot exceed 200 percent of the minimum wage. The rate development process and public authority hourly rate should be sent to the California Department of Social Services IHSS Fiscal Unit on the enclosed rate setting form for concurrence. See Attachment C. The Department of Health Services will perforin the final approval. When any increase in provider wages or benefits is negotiated or agreed to by a public 3 authority or nonprofit consortium,the county will use county only funds to fund both the county share and the state share, including any portion of employment takes,unless otherwise provided for in the annual Budget Act or appropriated by statute. The CMIPS will be used to do IP payroll and to track wages,benefits and public authority administrative costs. Public authority and nonprofit consortium costs will be invoiced by the counties to the IHSS Fiscal Unit on a quarterly basis. A sample of the public authority invoice and instructions for completing the Federal/State/County Reconciliation is enclosed. See Attachment D. Upon completion of the Federal/State/County Reconciliation,county staff should sum the administrative gross expenditures for the entire quarter(from pages 2 through.4 of the PA invoice)separately for PCSP and for Non-PCSP(lines 2C and lines 8C)and transfer the total amounts for PCSP and Non-PCSP to page I of the invoice under the Gross Expenditure column. Invoices should be submitted to the IHSS Fiscal Unit within 30 days after the end of each quarter.The IHSS Fiscal Unit will audit invoices against CMIPS and will monitor the 200 percent of minimum wage cap and any wages and associated costs exceeding minimum wage. Invoices will then be forwarded to CDSS Accounting,which will process only the administrative portion for reimbursement, since the services portion will be processed through CMIPS. CM--RS A screen similar to the County Summary(CSUM)screen will be created for Public Authority and Nonprofit Consortium. The Management Statistics Summary report will reflect the input from the new screens statewide and by county. Retailed instructions regarding those changes will be sent to all IHSS Program Managers. EORMS Advanced copies of the In-Home Supportive Services Program Public Authority/Nonprofit Consortium hate (Form SOC 449,Attachment C)and the Public Authority Invoice(Form SOC 448,Attachment D)are attached to this letter. The forms are being finalized,and the IHSS Fiscal Unit will notify PA counties once the forms are available. At that time,camera-ready copies of the forms can be obtained from the DSS Forms Management. 4 If you have any questions regarding the regulations,please contact Sharon Scott in the IHSS Policy Unit at(916)229-4597. For questions pertaining to funding,ratesetting or claiming and reimbursement,please contact Lisa Grech in the IHSS Fiscal Unit at(916)229-4595,and for any questions pertaining to CMIPS, please contact Josie Powers in the CI 'S Unit at(916)229- 4019, Sincerely, DONNA L.MANDELST"AM Deputy Director Disability and Adult Programs Division Attachments 5 PUBLIC AUTHORITY REGULATIONS ATTACHMENT A 34-753 SPECIAL DEFINITION'S (Continued) 34-753 (c) (1) Consumer means an individual who is a current or past user of personal care services, as defined by Section 30-757.14, paid for through public or private funds or a recipient of IHSS or PCSP. (2) (Continued) (3) (Continued) (4) (Continued) (d) through (rn) (Continued) (n) (1) (Continued) (2) Nonprofit consortium means anassociation that has a tax-exempt status and produces a tax exempt.status certificate and.meets the definition of a nonprofit organization, as contained in ONI.B Circular A-12.2 found at Federal Register, Vol. 45, No. 1.32, dated July 8, 1984. HANDBOOK BEGINS HERE (A) OMB Circular A-122 found at Federal Register, Vol. 45, No. 132, dated July 8, 1984, defines a nonprofit organization as one which: (1) Operates in the public interest for scientific, educational, service or charitable purposes; (2) Is not organized for profit making purposes; (3) Is not controlled by or affiliated with an entity organized or operated for profit making,purposes; and (4) Uses its net proceeds to maintain, improve or expand its operations. HANDBOOK ENDS HERE (o) (Continued) (P) (Continued) h (7) Public Authority means: (A) An entity established by the board of supervisors by ordinance, separate from the county, which has flied the statement required by Section 53451 of the Government Code, and (B) A corporate public body, exercising public and essential governmental functions and that has all powers necessary and convenient to carry out the delivery of in-home supportive services, including the power to contract for services and make or provide for direct payment to a provider chosen by a recipient for the purchase of services. Authority Cited: Sections 10553, 10554, and 1.2301.1, Welfare and Institutions Code; and Chapter 939, Statutes of 1992. Deference: Sections 10554,12300(c), 12341, 12301.6, 12304, 1.2346, 1.2308, 13302. 14132.95, 14132.95(e), and 14132.95(f), Welfare and.Institutions Code. 2 _......... ...................................................................................................................................... . .................................................................................................................................................................................................................................................................. ...... ....................... .................. .... ..... . ....... ......... ......... ......... __ _ _ ........ ...__..... .............. ..... Amend Handbook Section 30-765.113 to read. 30-765 COST LIMITATIONS 30-765 .1 (Continued) .11 (Continued) HANDBOOK BEGINS HERE A1.3 Welfare and Institutions Code Section 12300(g)(23) states: "Any recipient receiving services under bath Section 14132.95 and this article shall receive no more than 283 .hours of service per month, combined, and any recipient of services under this article shall receive no more than the applicable maximum specified in Section 12303.4." (See Section 30-765.11.) HANDBOOK ENDS HERE Authority' Cited: Sections 10553 and 10554,Welfare and Institutions Code; and Chapter 939, Statutes of 1992. Reference: Sections 12300 and 14132.95, Welfare and Institutions Code. 3 30-767 SERVICE DELIVERY NfETHODS (Continued) 30-767 .2 Counties may elect to contract with a nonprofit consortium or may create a public authority to provide for the delivery of IHSS. .21 The board of supervisors shall establish a public authority by ordinance. .211 The public authority shall be separate from the county. .Employees of the public authority shall not be considered to be employees of the county for any purpose. .212 The ordinance shall designate the governing body of the public authority and specify the qualifications of the individual members, the procedures for norrnination, selection, appointment, tenure and removal of members, and such other matters as the board of supervisors deems necessary for the operation of the public authority. (a) The board of supervisors may designate itself as the governing body of the public authority. (1) If the board of supervisors is the governing body„ the ordinance shall require the appointment of an advisory committee of no more than 11 members. (2) No fewer than 50 percent of the advisory committee shall be consumers as defined in Manual of Policies and Procedures Section 30-753(c)(1). (b) - If the beard of supervisors noes not designate itself the governing body of the public authority, it shall specify by ordinance the membership of the governing body of the public authority. (1) No fewer than 50 percent of the members of the governing body shall be consumers as defined in Manual of Policies and Procedures Section 30-753(c)(1). .213 Before appointing members to the governing body or advisory committee, the board of supervisors shall solicit recommendations from the general public and interested persons and organizations through a fair and open process which includes reasonable written notice and a reasonable time to respond. (a) The provisions at Section 30-767.213 shall be met by satisfying the requirements governing legislative bodies outlined in Government Code and other state and federal law, including, but not limited to, the Ralph M. Brown Act.(Government Code Section 54950 cc seq.) and the Americans with Disabilities Act. .21.4 Prior to initiating delivery of IHSS through a public authority, the county shall enter an agreement with the public authority specifying the purposes, scope or nature of the agreement, the roles and responsibilities of each party including provisions which ensure compliance with all applicable state and federal labor laws, and compliance with all statutory and regulatory provisions applicable to the delivery of IHSS. This agreement shall also specify the fiscal provisions under which the public authority shall be reimbursed for its performance under the agreement. The county, in exercising its option to establish a public authority, shall not be subject to competitive bidding requirements. .215 Prior to initiating the delivery of IHSS through a public authority, the county shall submit to the California Department of Social Services a copy of the agreement as spedified in Section 30-767.214 along with the following information concerning the public authority: (a) Organization chart of the public authority. (b) Funding provision for public authority costs, including how the proposed rate was developed. (1) The rate development process and the public authority hourly rate must be approved by Department of Health Servicesprior to initiating the delivery of services. (c) Public authority staffing classifications and duties. (d) A description of how the functional requirements of Welfare and Institutions Code Section 12301.6(e) will be met. HANDBOOK BEGINS HERE (e) The requirements of Welfare and Institutions Code Section 12301..6(e) are listed in Section 30-767.23. HANDBOOK ENDS HERE .216 If the public authority contracts with another entity to provide the deliver- of eliverof IHSS, the agreement shall satisfy the requirements of Manual of Policies and Procedures Chapter 23-600 relating to contracting. .217 All costs claimed for the delivery of services under an agreement as specified in Section.30-767.214 shall be claimed in compliance with criteria for rate setting found at Section F, attachment 4.19-B of the California Medicaid State Pian. (a) A county shall use county-only funds to fund both the county share and the state share of any increase in the cost of the program, including employment taxes, due to any increase in provider wages or benefits negotiated or agreed to by a public authority or nonprofit consortium unless otherwise provided for in the annual budget act or appropriated by statute. No increase in wages or benefits negotiated or agreed to pursuant to this section shall take effect until the Department has obtained the approval of the State Department of Health Services. .22 A county may contract with a consortium for delivery of services. .221 A consortium entering a contract under Section, 30-767.22 shall have a governing body composed as described in Section 30-767.212(b)(1), or shall have established an advisory committee composed as described in Sections 30-767.212(a)(1) and (2). .22.2 Such contracts shall be subject to the provisions of Manual of Policies and Procedures Chapter 23-600. .223 A consortium entering a contract under Section 30-767.22 shall be deemed to be the employer ofJESS personnel referred to recipients as described in Section 30-•767.23 for the purposes of collective bargaining over wages, hours and other terms and conditions of employment. .23 Any public authority or consortium shall provide the following minimum services: .231 Provide registry services to recipients receiving services pursuant to Section 30-767.23. (a) Assistance in finding providers through the establishment of a registry. (b) Investigation of the qualifications and background of potential providers listed on the registry. 6 (c) Establishment of a referral system under which potential providers are made known to recipients. .232 Provide access to training for providers and recipients. HANDBOOK. BEGINS HERE (a) Access to training for providers and recipients does not mean that the county or the Public Authority is under any obligation, (1) to provide the training directly, to pay for training provided in the community, to pay for the provider's time to attend or to accompany the recipient to training, to pay for transportation to the training, or to pay for any materials required by the training; or (2) to screen or be responsible for the content of any training it tells providers and/or recipients is available in the community; or ( ) to ensure that any provider or recipient attended/completed any training. HANDBOOK ENDS HERE .233 Perform any other function related to the delivery of IHSS. .234 Ensure that the requirements of the Personal Gare Services Program pursuant to Subchapter 19 (commencing with Section 1396) of Chapter i of Title 42 of the United States Code are met. .24 Any public authority may adopt reasonable rules and regulations for the administration.of employer-employee relations. HANDBOOK BEGINS HERE .241 The Employer-Employee Relations Policy for Public Authorities Delivering In.-Home Supportive Services is available from the California Department of Social Services as a model for public authorities. .Public authorities may adopt, reject, or modify,the policy in part or in its entirety. HANDBOOK ENDS HERE .25 Public authorities and consortia must submit cost reports and such other data as required for the Case Management, Information and Payrolling System (CMIPS). 7 .26 Any county that elects to provide for in-home supportive services pursuant to this section shall be responsible for any increased costs to the CMIPS attributable tc such election. Tle Department shall collaborate With any county that elects.to provide in-home supportive services pursuant to this section prior to implementing the amount of financial obligation for which the county shall be responsible. .3 (Continued) HANDBOOK BEGINS.HERE .4 (Continued) .5 (Continued) .6 (Continued) HANDBOOK ENDS HERE Authority Cited: Sections 10553 and 10554, Welfare and Institutions Code; and Chapter 939, Statutes of 1992. Reference: Sections 12301.5, 12302, 12302.1, and 14132.95, Welfare and Institutions Cade and Section 54950 et seq., Government Code. 8 ...................................................................................._ .......................................................................................................................................................................................................................................................... ....................................................................................................... ..... ............................................................................................................................................................................................ .................... ........................................ APPENDIX J REFERENCE TO DEPAR'T'MENT OF JUSTICE STUDY I Looking for Funds to Expand Medigap Coverage .)r Improve Services? Under Scrutiny A number of national and local foundations make y The National Bipartisan Commission on the Future grants available to nonprofit organizations that provide of Medicare is looking closely at Medigap policies and we acrd services to seniors. Consider the following: the coverage they provide.Analysts believe that - Blount Foundation supports education and health Medigap insurance encourages ovenstilization of Medi- programs. Write to D. Joseph McInnes, President, BF. rare covered benefits,pointing to substantially higher Part 13 costs among policy holders. 4520 Executive Park Dr., Montgomery,AL,36116. The commission is considering such options as: ban- - Nathan Cummings Foundation focuses on improving : ning Medigap;taxing Medigap premiums;requiring end-or-life cam. Call Charles Halpren at 212-787-7300. : Medigap insurers to become full risk plans;issuing : rebates to beneficiaries who do not have Medigap cov- The Luke 8. Hancock Foundation encourages indi- vidual initiative and builds community programs.Con- : erage,integrating Medigap features into Medicare cov. tact Ruth Ramel at 650-321-5536. : erage;and reforming Medicare to make Medigap : unnecessary. Changes such as these would force many • F.B.Heron Foundation supports community-based : beneficiaries to pay more than the$2,733 national aver- organizations working with se'nio'rs. Faix requests to : age in out-of-pocket expenses. Already,one in 10 F8HF at 212-649-5861. : Medicare beneficiaries cannot afford to pay any out-of. • Charles Stewart Mott Foundation fosters community : pocket Medicare expenses, building and favors replication projects.Visit the website at www.mott.org. y Criminal Background • Piper Jaffrey Companies Foundation has a new em- : Checks May Be Overrated phasis on affordable housing.Call 612-342-5501. The Department of Justice, in conjunction with the Dennis and Phyllis Washington Foundation funds American Bar Association,studied employers' use of ing centers and services.Call 40&523-1300, 4- background screening methods and found that less is often best. The study found that agencies that conducted a ba- sic screening(includes interview, reference chock mid written application)immediately rejected 6.4 percent of C&HSAs Mscount Group all applicants.Those that performed a criminal back- Purchasind Program ground check-in addition to a basic screening elimi- nated only 5.7 percent of applicants. Moreover, 10 C64 Ll QJAI percent of all employers who performed criminal back- ground checks reported substantial client abuse by em- R NoMemberihip Feet ployees whereas just 4.7 percent of employers who L-51 Low"t 110"We Rice, used basic screening procedures reported abuse. 91 Man''Jacturer Diw-vant-P HIV/AIDS on the Rise rir Professional Purclusing Pow,, @;, Purchaiing Eduz&tion&Consulting Among the Elderly Loo4ing for Better Service. Prices xnl Value? H I VIA I DS is growing faster among older adults that, any other age group.Area Agencies on Aging in Cali- JOIN THE GROUP! fornia. Florida and Arizona are devoting resources to education and case management in order to reverse the trend. To find out more.contact the following leaders in H I V/A I DS care among the elderly: - San Diego AIDS Waiver Program-Rick Wanne. 619-495-5097. ZAAW PWAOIAO Stf"kV# . National Association of HIV Over Fifty(NAHOF)- I(XII 1.tAntu V.VtAge j1aAw,&v,Zusw#4(XI 816-561-8784. Ala".%:A Q4.401- . Academy for Educational Development(ask for the mild Medicare report) - 202-884-8931. . I lealth Care Education Association(ask about-The Forgotten Tenth"video)- 760-323-4032. 4 -Juiy24.1998 Othfornia Associsttioa of domes anti Services for the Aging APPENDIX K ASSEMBLY BILL 857 AB 857 Assembly Bill- CHAPTERED Pagel of BILL INTUINMER: AB 857 CHAPTERED BILL TEXT CHAPTER 911 FILED WITH SECRETARY OF STATE SEPTEMBER 26, 1996 APPROVED BY GOVERNOR SEPTEMBER 25, 1.996 PASSED THE ASSEMBLY AUGUST 31, 1996 PASSED THE SENATE AUGUST 14, 1996 AMENDED IN SENATE JULY 16, 1.996 AMENDED IN SENATE JULY 7, 1996 AMENDED IN SENATE JUNE 13, 1996 AMENDED IN ASSEMBLY JANUARY 29, 1996 AMENDED IN ASSEMBLY -JANUARY 9, 1996 INTRODUCED BY Assembly Member Woods (Coauthor: Assembly Member Alpert) (Coauthor: Senator O'Connell) FEBRUARY 22, 1995 An act to amend Section 15660 of the Welfare and Institutions Code, relating to public social services. LEGISLATIVE COUNSEL'S DIGEST AB 857, Woods. In-horne supportive service providers: criminal record checks. Existing law provides for the in-Home Supportive Services (JESS) program, under which, either through employment by the recipient, or by or through contract by the county, qualified aged, blind, and disabled persons receive services enabling them to remain in their own homes. Counties are responsible for the administration of the IHSS program. Existing law provides that the Department of Justice shall secure any criminal record of a person to determine whether the person has been convicted within the last 10 years of any felony or of specified offenses if an employer of the person requests the determination and submits fingerprints of the person to the Department of Justice. This bill would include a recipient of in-home supportive services within the definition of employer for those purposes, and would specify that any local law enforcement agency or officer may take fingerprints for that purpose. This bill would impose a state-mandated local program by requiring Counties to notify IHSS recipients and applicants upon application or the annual redetermination, or upon the changing of providers, of the availability of the criminal record check, and that it can be performed by the Department of justice. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement, including the creation of a State Mandates Claims Fund to pay the costs of mandates that do not exceed $1,000,000 statewide and other procedures for claims whose statewide costs exceed $1,000,000. This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory Provisions. AB 857 Assembly Bill- CHAPTERED Page 2 of 3 THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 15660 of the welfare and Institutions Code is amended to read: 15660. (a) The Department of Justice shall secure any criminal record of a person to determine whether the person has been convicted within the last 10 years of a sex offense against a minor, a violation of Section 243.4, 273x, 273d, or subdivision (a) or (b) of Section 368, of the Penal Code, theft, robbery, burglary, or any felony, if both of the following conditions are met; (1) An employer of the person requests the determination and submits fingerprints of the person to the Department of Justice. For purposes of this paragraph, "employer" includes, but is not limited to, an in-home supportive services recipient, as defined by Section. 12302.2 and any recipient of personal care services under the Medi-Cal program pursuant to Section 14132.95. (2) The person is unlicensed and provides nonmedical domestic or personal care to an aged or disabled adult in the adult's own home. (b) (1) If it is found that the person has been convicted within the last 10 years of a sex offense against a minor, a violation of Section 243.4, 273x, 273d, or subdivision (a) or (b) of Section 368, of the renal Code, theft, robbery, burglary, or any felony, the Department of Justice shall notify the employer of that fact. If no criminal record information has been recorded, the .Department of Justice shall provide the employer with a statement of that fact. (2) Any employer may deny employment to any person who is the subiiect of a report under paragraph (1) when the report indicates that the person has committed any of the crimes identified in paragraph (1) . (3) Nothing in this section shall be construed to require any employer to hire any person who is the subject of a report under paragraph (1) when the report indicates that the person has not committed any of the crimes indicated in paragraph (1) . (c) (1) Fingerprints shall be on a card provided by the Department of Justice for the purpose of obtaining a set of fingerprints. The employer shall submit the fingerprints to the Department of Justice. Within 30 calendar days of the receipt of the fingerprints, the Department of Justice shall notify the employer of the criminal record information, as provided in this subdivision. If no criminal record information has been recorded, the Department of Justice shall provide the employer with a statement of that fact as soon as possible, but not later than 30 calender days of receipt of the fingerprints. If new fingerprints are required for processing, the Department of Justice shall, as soon as possible, but not later than 30 calendar days from the date of receipt of the fingerprints, notify the employer that the fingerprints were illegible. (2) Fingerprints may be taken by any local law enforcement officer or agency for purposes of paragraph (1) . (3) Counties shall notify any recipient of, or applicant for, in-home supportive services or personal care services under the Medi-Cal program, upon his or her application for in-home supportive services or personal care services or during his or her annual redetermination, or upon the recipient's changing providers, that a criminal record check is available, and that the check can be performed by the Department of Justice. (d) The Department of Justice shall charge a fee to the employer to cover the costs of administering this section. (e) It is the intent of the Legislature that the Department of justice charge a fee to cover its cost in providing services in accordance with this section to comply with the 30 calendar day requirement for provision to the department of the criminal record information, as contained in subdivision (c) . SEC. 2. Notwithstanding Section 1.7610 of the Government Code, if AB 857 Assembly Bill- CHAPTERED Page 3 of 3 the commission on state Mandates determines that this act contains costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 .'commencing with Section 17500) of Division 4 of Title 2 of the Government Code. If the statewide cost of the claim for reimbursement does not exceed one million dollars ($1,000,000) , reimbursement shall be made from the State Mandates Claims Fund. Notwithstanding Section 17580 of the Government Code, unless otherwise specified, the provisions of this act shall become operative on the same date that the act takes effect pursuant to the California Constitution. APPENDIX L RECOMMENDED PUBLIC AUTHORITY STAFF JOB DESCRIPTIONS Contra Costa County March 1999 In-Home Supportive Services (IHSS) Public Authority, EXECUTIVE DIRECTOR (Comparable to Social Service Division Manager) Definition• Under general direction of the Public Authority Governing Board, provides overall policy and program direction for the Public Authority in cooperation with the Public Authority Advisory Committee, is responsible for management and administration of the Public Authority, including hiring, training and supervising Public Authority staff; acts as liaison to Board of Supervisors, County Administrator and County Departments; provides staff support to the Public Authority Advisory Committee; represents the Public Authority at the local and state level regarding Public Authority;issues;and is responsible for compliance with all relevant County. State and Federal laws, regulations and agreements. Distineuishing Characteristics: The incumbent has overall responsibility for the policy and program direction. management and administration of the Public Authority; provides coordination/liaison with Board of Supervisors. County Administrator, Social Service Department, Human Resources Department,County Counsel and Risk Management; provides supervision and administrative direction to Public Authority staff The incumbent's responsibilities will require regular travel to different locations within the County and occasional travel outside of the County. ManagementResRonsibilities: ■ Hires and supervises Public Authority staff, and ensures the orientation. 'training, and development of personnel through regular reviews and evaluations of performance ■ In cooperation with the Public Authority Advisory Committee, develops overall policy goals. objectives and operating procedures for the delivery of services ■ Establishes priorities and develops strategies to achieve program objectives ■ Determines funding needs and options, oversees budget preparation and assures effective monitoring of fiscal performance ■ Serves as principle staff to Public Authority Advisory Committee ■ Participates in labor negotiations and administration of labor contracts Analyzes and reports on proposed Federal and State legislation as they affect areas of responsibility ■ Represents the Public Authority and explains and interprets policies.procedures. legislation and regulations for legislative bodies, boards, commissions and other groups Represents the Public Authority on the Public Authority Council Assists with preparation of County/Public Authority Interagency Agreement and monitors Public Authority compliance with requirements of Interagency Agreement ■ Assists with preparation of Public Authority rate application and documentation materials 1 Minimum Qualifications Educations Possession of a baccalaureate degree from an accredited college or university, with a major in business administration, public administration, human resources management, organizational development or closely related field. Experiences Four years of full-time experience or its equivalent in an upper level management position in a public or private social service agency. Substitution for Experience: Possession of a master's degree in business administration, public administration, human resources management, organizational development or closely related field may be substituted for one year of the required experience. Substitution for Education and Academic Maior. Additional qualifying experience may be substituted for the required education up to a maximum of 2 years.One additional year of qualifying experience may be substituted for the required academic major. Knowledge, Skills and Abilities. Knowledge of: • In-Home Support Services system in California,and Public Authority and IHSS laws. regulations and funding • Elderly/disability issues • Management data processing applications and computer technology • The theory, principles and practices of governmental financial administration, budgeting, contracts administration, program management and accounting ■ The principles. practices and techniques of personnel administration, affirmative action, labor relations, counseling, supervision, and training • The principles. methods and procedures of community organization, consultation, and public relations Ability to: ■ Plan, organize, direct and coordinate the work of a professional staff • Administer, plan. organize and direct comprehensive programs, and administrative service operations * Analyze and evaluate complex program and administrative problems and recommend effective courses of action • Develop short and long range budget plans that reflect program needs; • Develop and utilize all available resources • Analyze new or proposed Federal and State legislation and evaluate and report on the impact on program operations • Represent the Public Authority for In-Home Support Services with other boards, committees, government and community agencies,departments and officials Fs dir_;ob des 3/06/99 2 Contra Costa County March 1999 to-Homme Supportive Services (IHSS) Public Authority PROGRAM MANAGER (Comparable to ASA 111) Definition: Under supervision of the Executive Director, has responsibility for day-to-day implementation of policies and procedures related to the Public Authority IFISS provider registry, provider/consumer training activities and support services; responsible for office management, personnel transactions, staff support to committees of the Public Authority Advisory Committee; and supervision of technical and clerical personnel. Distinguishine Characteristics: The incumbent functions as a key administrative assistant to the Executive Director with responsibility for directing the day-to-day operations of Public Authority services, office management and personnel transactions, supervises staff, and serves as staff to committees of the Public Authority Advisory Committee. Guidelines for action and supervision are received from the Executive Director. The incumbent's responsibilities will require travel to different locations throughout the County. Management Resl2onsibilities: • Supervises registry and clerical personnel • Directs day-to-day operations of the provider registry, provider/consumer training activities and support services, office management and personnel transactions • Assists Executive Director with on-going design, development and implementation of Public Authority services • Develops or assists in the development of policies and procedures,operating manuals. workflow charts, narrative and statistical reports • Prepares and/or maintains statistical, fiscal, payroll and personnel information • Conducts analytical studies of organizational, budgetary,and administrative issues related to the Public Authority • Researches and compiles informational materials from sources both inside and outside the office to which assigned • Collects data and prepares analysis in connection with Public Authority budget; and assists with preparation of annual budget • Initiates specific correspondence independently for signature by Executive Director or other appropriate staff Minimum Qualifications Education: Possession of a baccalaureate degree from an accredited college or university, with a major in business administration. public administration. human resources management or closely related field. Experience: Three years of full-time experience or its equivalent in an administrative or staff capacity performing administrative, budgetary, and personnel or human resources :management functions. Substitution for Education: Additional qualifying experience may be substituted for the required education up to a maximum of 2 years. One additional year of qualifying experience may be substituted for the required academic major. Substitution for Experience: Possession of master's degree in business administration, public administration,human resources management or closely related field may be substituted for one year of the required experience. Knowledge, Skills and Abilities: Knowledge of. ■ The principles and practice of personnel administration and supervision The methods and techniques of work organization, simplification and layout • Modem office methods, forms and equipment ■ Management data processing applications and computer technology ■ Statistical methods used in administrative and budget analysis ■ The principles and practice of budget analysis, formulation and control • The fundamentals of accounting • Public Authority and IHSS laws, and regulations • Elderly/disability issues Ability to: • Organize, supervise and direct work of subordinate staff • Do program planning and development • Develop and maintain policies and procedures • Reason and recommend solutions to program and administrative problems • Gather and analyze data • To interpret rules and regulations • Organize and write reports frog manae job cies 3/36/99 2 Contra Costa Count-*, March 1999 In-Home Supportive Services(IHSS) Public Authority OFFICE MANAGERJSECRETARY (Comparable to Clerk, Senior Level) Definition.• Under supervision of the Program Manager, oversees daily office management and operations, including receptionist responsibilities; provides clerical support to Public Authority staff and Public Authority Advisory Committee members and committees; and assists Program Manager with development and review of office policies and procedures. Distinguishing Characteristics: The incumbent will perform varied and complex clerical work of a highly responsible nature under limited supervision. The incumbent's responsibilities include day-to-day office management and operations, including receptionist responsibilities,providing clerical support to Public Authority staff and Public Authority Advisory Commit-tee members and committees, and assisting the Program Manager with development and review of office policies and procedures. Guidelines for action and supervision are received from the Program Manager. Typical Tasks• • Arranges for meetings, schedules meeting rooms. posts meeting notices, prepares agendas and summarizes meeting results as required ■ Requisitions, stores and distributes office supplies and keeps a record of supplies needed, received and issued • Receives and screens visitors and telephone calls and takes messages or refers calls to appropriate person • Provides factual information which may require the interpretation and application of policies and procedures • Opens and sorts in-coming mail and attaches pertinent back-up materials and processes outgoing mail • Types drafts and finished documents. including letters, reports and mernoranda from stenographic notes. minutes of meetings, brief instructions or printed materials • Reviews finished materials for completeness, accuracy. format, compliance with policies and procedures. and appropriate language usage ■ Operates office machines including multi-line telephone. photocopier, fax, calculator and computer • Organizes and maintains various Public Authority records and files, retrieves information from files and purges files as required • Researches and compiles informational materials from sources both inside and outside the office to which assigned • Prepares or assists in the preparation of narrative and statistical reports ■ Assists the Program Manager with development and review of office policies and procedures Minimum Qualifications Ability to accurately type reports, letters and memoranda using a computer. Ability to operate commonly used office machines. Experience: Three years of full-time or its equivalent of increasingly responsible clerical experience. Knowledge,Skills and Abilities- Knowledge bilities: Knowledgee of: ■ Clerical procedures and practices • Office management procedures and practices • Correct punctuation, spelling,grammar and a good vocabulary • Filing, indexing and cross-referencing methods • Operation of commonly used office machines • Word processing applications and computer technology Ability to: • Accurately add, subtract, multiply and divide including decimals and percentages • Operate commonly used office machines and computer applications • Initiate and answer correspondence independently • Prepare clear and concise reports. letters and memoranda • Understand and carry out oral and written instructions • Ability to read, understand and interpret written material • Deal effectively. tactfully and courteously with the public and technical and professional personnel • Learn Public Authority and IHSS laws and regulations • Bilingual: Speak and understand both English and Spanish Dolce manag sec joh des 3/016 99 2 Contra Costa County Marcii 1999 In-Home Supportive Services (IHSS) Public Authority REGISTRY/TRAINING SPECIALIST (Comparable to Administrative Analyst) Definition• Under supervision of the Program Manager,implements policies and procedures related to the Public Authority IHSS provider registry, including registry database management; implements policies and procedures related to IHSS provider and consumer training and support services: and assists with receptionist and clerical tasks. Distinpuishing Characteristics: Incumbents work under close supervision receiving instructions on priority of projects and on the work methods and techniques to be followed in completing work assignments. The incumbent's primary responsibilities include day-to-day operation of the provider registry; provision. coordination and monitoring of provider and consumer training; and provision of provider and consumer support services. The incumbent's primary responsibilities will require regular travel to different locations throughout the County. TYP ►ical Tasks: • Recruits providers for the registry,assists providers with registry application and intake process, checks provider references and background, conducts provider orientations and monitors provider follow-up • Conducts consumer intakes. generates lists of providers for consumers. refers providers to consumers and conducts consumer follow-up • Manages/maintains computerized provider registry database • Develops consumer and provider training curriculum • Recruits trainees for provider training • Plans, coordinates, conducts and monitors consumer and provider training activities. including provision of training on appropriate techniques of providing personal care, use of adaptive equipment, etc. • Provides consumer and provider support services, including conflict resolution • Regularly travels to different locations throughout the County to provide consumer/provider training and support services • Prepares or assists in the preparation of narrative and statistical reports • Organizes and maintains various Registry and training records and files 1 Minimum +Qualifications Education: Possession of a baccalaureate degree from an accredited college or university, with a major in social work. vocational rehabilitation. human resources management, health. physical or occupational therapy or closely related field. Experience: Three years of full-time experience or its equivalent in an administrative or staff capacity performing social work, vocational rehabilitation,human resources management, in-home provider registry, physical or occupational therapy, or health related functions. Substitution for Education: Additional qualifying experience may be substituted for the required education up to a maximum of 2 years. One additional year of qualifying experience may be substituted for the required academic major. Knowledge, Skills and Abilities: Knowledge of: • Job development, employee recruitment, interviewing, screening, orientation and training techniques and practices • Computer database applications • The home-care industry and home care registries • Elderly and disabled home-care needs and issues • Appropriate techniques of providing;personal care, use of adaptive equipment. etc. • Conflict resolution techniques Ability to: • Recruit, interview, screen. orient and train and refer Registry providers • Manage/maintain computerized provider registry database • Plan, coordinate, conduct and monitor consumer and provider training and support services activities, including ability to train in appropriate techniques of providing personal care, use of adaptive equipment, etc • To gather and analyze data • Read, understand and interpret written material • Write and organize reports • Assist in program planning and development • Learn Public Authority and IHSS, laws and regulations • Bilingual: Speak and understand both English and Spanish Rep training jab des 3/06/94 2 APPENDIX M SAMPLE CONSUMER SA'T'ISFACTION SURVEYS CONSUMER. ATI AC TION SURVEY Consumer. Today's Date: erson answering survey (if not consumer): Date List Was Sent (last list, if more than one): 1. I received a list of workers within five working days of my request. r QYes QNo (If not, how many days?) 2. The list of workers I received was easy to understand and contained important information. QYes QNo 3. I was able to find a.worker from the list you sent me. QYes �f yes: At what date slid you make the decision to hire a worker's QNo (If no, why not?) Ifno.• The reason is because: (a)(Consumer Cause] I decided that I did not want a home care worker. I changed my mind about ghat kind of worker I wanted and will not need your help. I decided to put the search on hold. N[Consumer Cause] I found someone on my own or decided to retain my current worker. Did the Public Authority provide inforniation,counseling or assistance in locating a worker on your own or in deciding to retain your current worker? Yes 0 No Cl ,If yes, was the Public Authority. 0 Not helpful 0 Helpful 0 Very Helpful 0 [List Problems] The workers did not return my calls. The workers said they were not available to work. (d) [Difficult to Match] I was looking for which was hard to match. (For example, 2 hours per week, 1 hour per day at midnight, short shift in Half Moon Bay with a car.) (e) [Worker Cause) The worker did not appear to the fust interview or to the first day of the job. (f) [Pending) I am still looking for someone. I am willing to wait for the perfect person to come along. I am not in a harry, but I would like someone. The Public Authority staff were: Q Not helpful Q Helpful Q "Very helpful 5. Having a Registry available is: Q Not important Q Important Q Very important Do you have any suggestions on haw we can improve our services? Consumer Evaluation OF HOMECARE WORKER To he done 1 months follon ng employment Worker's Nam: Consumer's Name- Home Phone: Contact Person: Phone: Start Date:,_______�� .� Quality of Work: Excellent Good Fair Poor Dependability: .Excellent Good pair„ Poor Attitude: Excellent Good Fair Poor Cooperation: Excellent Good Fair Poor Honesty: ExcellentGood � Fair Poor Accept Supervision: Excellent Good_ Fair Poor Initiative: Excellent Goad Fair Poor Ability to learn: Excellent Good._ Fair Poor Is there any reason you can give why this person should not be doing home care Yes/No Remarks Dame of person completing this evaluation: Date; SW: W.Persmul rift � nxl Pity APPENDIX N PERFORMANCE MEASURES USED BY OTHER PUBLIC AUTHORITIES PERFORMANCE MEASURES USED BY OTHER PUBLIC AUTHORITIES 1. 90%of consumers will indicate receiving provider referrals within 5 days of request. 2. 85%of consumers using the Registry will find a provider with Registry assistance. 3. '70%of consumers using the Registry will find a provider within 45 days. 4. 90%of consumers will indicate overall satisfaction with registry services. 5. 80%of Registry matches will last a minimum of 60 days. 6. 90% of consumers will indicate satisfaction with quality of Registry provider job performance. (Survey to be conducted two months following consumer employment of Registry provider). 7. 375 providers will receive a minimum of 2 hours training through the Public Authority during a one year period. APPENDIX O SAMPLE PROVIDER SA'T'ISFACTION SURVEY Home Care Provider Satisfaction Survey Questions to be asked o,f prvvfders 60 days after they first called the registry asking to he&ted Provider: Today's Date: How long did it take the registry's staff to return your first call when you applied ? UI spoke to someone right away,Ua few hours,Q1 day,02 days,03 days,Ua week or more How would you rate these statements? 1. "I was treated with courtesy, respect and fairness by the registry staff." QStrongly agree,ClAgree somewhat,UDisagree somewhat,UStrongly disagree 2. "The Public authority staff'were helpful." UStrongly agree,UAgree somewhat,UDisagree somewhat,UStrongly disagree 3. "Getting listed with the registry was a reasonably simple, straightforward process." UStrongly agree,UAgree somewhat,QDisagree somewhat,UStrongly disagree 4. "Laving the registry available is helpful and important." UStrongly agree,QlA gree somewhat,QDisagree somewhat,QStrongly disagree 5. "The registry helped me to find IHSS work." UStrongly agree,UAgree somewhat,UDisagree somewhat, UStrongly disagree Overall, how would you rate your experience with the registry? (Circle one number): 10 9 8 7 6 5 4 3 2 1 (Really great) (Adequate/Fair) (Really bad) Do you have any suggestions on haw we could improve our performance? APPENDIX P RECOMMENDED PUBLIC AUTHORITY BUDGET,RATE AND MATE NARRATIVE RECOMMENDED Contra Costa County IHSS Public Authority FY 9912000 Budget&Rats ITEM BUDGET CFSE�VtCEBSt $5-76001_- _ - ----1 2 EP 8 �ahttea 8.afi2°R 52,271 d88 $2 271 46 _ _.__ SQ 4838 __ _jAdmin#sth'etivs Salaries _T_ Executive Director j� $7#M Uo€i _ _ s7t tH1! _ _ - _.- Farts ram saa4et _ -� _— y��� _w- —$105�t7oQI UtB l�rY E35t 335 000,_ Total Saiari+w l _ 52i8,00J 0 L5286 ti0 _5Q OSd7 Y� a 4 �Adm#nhWativai i� tita$.`taycta�it36_1 �3$ fe_ _ _�_ S93y8Qc3 Administrative Travel $ toast Ata w nk__ $a 000 { � $6 aoo,_ $0.00121 s YtuUie Avera e�$30 r mntN11 rnerrlbetsi _.____fi�___ Ql 3, ro ' so 7 S2aUone $800 _ - - � $BD0 i $0.iia01 s __ ►�Slingte4to-sPsmerEeJsugp#t83�$1C�J tittrhthh__ ______ ____-$1200___. _ . _ __ _� ___. _$1_230 _sq.00q� Comm.m.Travoi/Conkran es - 1 -Adv.Comm.Train__Fug.. _ _._ S20,0001 $0.0022 a St tity_&Workers Componsation tns. 12-_ Trasnirrg csts�36 aeasux1s1S30iter sesstgnl_1� _ _ I _� 510 8{}4 __ --.A- 1_ _. $!1}840 j_ SQ Oa22 13 .Ttairl#ng gerids00 x E22,_500I _.., $0 tF{t3S; 14 1iii?eY. 2 35 P ft}let month --.--- 528�2C70� $24 2001 $0 11488 — to - j 15 K»ce_furrniture _ _ -..__._$f1s000;_ _. _.._�._. . .._-511,000 _ ;O,Oaa - _ _ _ ;Fqument - ' Five cornouters&software $20,0001 _ y S2a,0{10 v Sa at1t1 _ 7_- i. _ ._FAY rrt C#ilrroe&_#nsta#lgbgn-!- __ _ _.. $1 000 f_ $1.000 I ;0-00021---.- i e ...:Equipment{rental}photocopy ... _$8 _380 - -_ SB 380 $0.0013 i 9 .. Telephone lines&inwAilatoP 20 e $8 _Posta e _ __-_._ __. _ _. �$t 2 725. ._.. _$Q QQi4�- - 21 _ _ _O#1ic�s Stspp#ts __._ QQ13 S 9� s 22 P.0videt recruitmerst(adver63 tag) 23 #3rixtting-- 57000 j_ ST,Ct0t1 _3tl aa141 + 55130 _ { 24 Books,Periodicals $0.00011 odirs#s _ Isrofeas[ana# i _ t aai3�i 26 Annual audit Costs - -- - 25 _ AC�itrntl sAfVECxss _.$4t7{SCI Labor Re atlons Sernces -__ _ __ ; 27 28 Human Resources Start Liaison 535 1700 j ! `__ $35,0,00 QU7f _ 29 30Soc ry StafF i raison 536�0n0 _ - 538 X00 i -40.0075 s___--E isk h4ttzzaQement 5ervirs�5 51,000 t $1,000! $0.00021 32 lTMrogramm i9 n _ _ _ $T5001 _ __ 57,500! -SQaat6 - _ _ 33 _ Consu#trrfs(txYs.gssess.L prug eva4.,eventa} _..1_ _ 58 Qao _. _ $8 000 34 'Reasonable Acoo mmodatttons_ 8_ ._. _ 58,500 $a.{1t313{ s �Mtscelisneoua_>^xperlSee,--. --- !_ _ 58.5001 - - T ; TOTAL' 531,1701854 1 .___..534,446,4691 `_ _f72d,385 $8.36141 _..__. CCCOBUOO.WK4 03AAM 02:18 PAA CONTRA COSTA COUNTY IHSS PUBLIC AUTHORITY BUDGETIRATE NARRATIVE FISCAL YEAR 1999—2000 LINE ITEM DESCRIPTION IP Wages: Represents 4,900,000 service hours at $5.75 per hour(,minimum wage). Amount: $28,175,000 Portion of rate: $5.7500 2. IP Employer Taxes: Represents 8,062%of total cost of 4.900,000 service hours at$5.75 per hour. Amount: $2.271.469 Portion of rate: $0.4636 3. Administrative Salaries: Includes Executive Director- Program Manager. Office Manager/Secretary and 2.5 FTE Registry and Training Specialists. Salaries mirror salaries for comparable County classifications. Amount: $268.000 Portion of rate: $0.0547 Administrative Benefits & Taxes: Includes administrative employee benefit package and employer taxes on administrative salaries. Represents 35%of total cost of administrative salaries. Amount: $93.800 Portion of rate: $0.0191 5. Administrative Travel-Mileage: Includes $125 per month for 4 staff members. Amount: $6,000 Portion of rate: $0.0012 6. Advisory Committee Expenses-MileageAncludes average mileage reimbursement of $30 per month for 11 Advisory Committee members, Amount: $3.900 Portion of rate: $0,0008 7. Advisory Committee Expenses-Stationery: Amount: $600 Portion of rate: $0.0001 8. Advisory Committee Expenses-Meeting refreshments and supplies: Includes $100 per month. Amount: $1,200 Portion of rate: $0.0002 9. Staff and Advisory Committee Travel/Conferences: Allows 4 attendees at conferences; average conference cost $500. Amount: $2,000 Portion of rate: $0.0004 10. Staff and Advisory Committee Training: Includes 4 group Facilitation Training sessions for staff and Advisory Committee. Amount: $2,000 Portion of rate: $0.0004 11. Liability and Workers Compensation Insurance: Amount: $20,000 Portion of rate: $0.0041 12. Provider Training-Training Costs: Includes training 900 providers per year at 36 training sessions with an average attendance of 25 trainees (75 per month), at$300 per session to cover costs, e.g.. trainer, supplies, refreshments. Amount: $10.800 Portion of rate: $0.0022 13. Provider Training-Training Stipends: Allows for a$25 training stipend per session for 900 providers attending training sessions. Amount: $22,500 Portion of rate: $0.0046 14. Office Expenses-Occupancy: Provides 1,000 sq. ft. of office space including utilities and janitorial at$2.35 per sq. ft., per month Amount: $28,200 Portion of rate: $0.0058 15. Office Expenses-Office Furniture: Provides desks,chairs, workstations, tiles and bookcases for 5.5 staff($10,000); and audio-visual equipment($1,000). Amount: $11,000 Portion of rate: $0.0022 16. Office Expenses-Equipment(nese): Provides computer hardware and software for 5 staff at $4,000 each. Amount: $20.000 Portion of rate: $0.0041 2 7. Office Expenses-Equipment (new): Includes FAX machine purchase and installation. Amount: $1.000 Portion of rate: $0.0002 18. Office Expenses-Equipment(rental): Includes photocopy rental at $530 per month. Amount: $6,360 Portion of rate: $0.0013 19. Office Expenses-Telephone: Includes 10 telephone line installation ($1.000); and 10 telephones at $50 per month($6.000). Amount: $7,000 Portion of rate: $0.0014 20. Office Expenses-Postage: Includes monthly mailings to 5,000 providers ($900); and $100 per month additional mailing cost. Amount: $12.000 Portion of rate: $0.0024 211, Office Expenses-Office Supplies: Includes initial purchase of stationary. desk supplies. etc. ($3,700); and monthly replenishment of office supplies ($3,025). Amount: $6,725 Portion of rate: $0.0014 22. Office Expenses-Provider Recruitment: Represents costs for advertising for providers in local newspapers. Amount: $6.500 Portion of rate: $0.0013 23. Office Expenses-Printing: Includes 1,000 training manuals per year, other consumer and provider related materials and informational fliers. Amount: $7.000 Portion of rate: $0.0014 24. Office Expenses-Books, Periodicals: Amount: $500 Portion of rate. $0.0001 25. Professional Services-Aecounting: Annual accounting costs. Amount: $4M0 Portion of rate: $0.0008 26. Professional Services-Accounting: Annual audit costs. Amount: $00.00 first year Portion of rate: $00.00 first year 27. Professional Services-human Resources: 1EDA, contracted labor relations activities. Amount: $30,000 Portion of rate: $0.0061 28. Professional Services-Human Resources: Duman Resources staff liaison, management of labor relations activities. Amount: $35,000 Portion of rate: $0.0071 29. Professional Services-Legal Services: Provides 500 hours per year at$108 per hour. Amount: $54,000 Portion'of rate: $0.0110 30. Professional Services-Social Service Department: Social Service Department .5 FTE staff liaison. Amount: $36,$00 Portion of rate: $4.0075 31. Professional Services-Risk Management: Provides risk analysis of exposure to loss, consultation on insurance coverage and arranging for insurance coverage. Amount: $1,000 Portion of rate: $0.0002 32. Professional Services-IT/Programming Expenses: Provides 100 hours of computer programming and support services at$75 per hour. Amount: $7,500 Portion of rate: $0.0015 33. Professional Services-Consultants: Provides 100 hours of consultant time at $60 per hour for needs assessment, program evaluation, event planning, etc. Amount: $6,000 Portion of rate: $0.0012 34. Reasonable Accommodations: Provides reasonable accommodations, e.g., sign language interpreters, assistive listening system,adaptive equipment. Amount: $6,500 Portion of rate: $0.0013 4 35. Miscellaneous Expenses: Amount: $6,500 Portion of rate: $0.0013 Total Hourly Rate: The hourly rate is computed by adding total services costs and total administrative costs and dividing by the number of IHSS hours. $30,446,469 + $724,385 =$31,170,8541(4,900,000) =$6.3614 CC CO PA Budg and ratenarrative 3/06/99 APPENDIX Q ORGANIZATIONAL CHART OF THE PUBLIC AUTHORITY 40 ) t> C: s 16 04 00 ewl 0. s � s A A t 3 t d t i t t s s g.- � 4 ° � 00 T� r s t r s t r $ r Y r s s r r s r r � c r APPENDIX R PUBLIC AUTHORITY STAFFING, CLASSIFICATIONS AND DUTIES CONTRA COSTA COUNTY IN-HOME SUPPORTIVE SERVICES PUBLIC AUTHORITY STAFF POSI`T`IONS, CLASSIFICATIONS AND DUTIES TITLE CLASSIFICATION DUTIES Executive Director Comparable to Social Under general supervision,provides overall policy and Service Division program direction for the Public Authority in Manager cooperation with the Advisory Committee; is responsible for management and administration of the Authority, including hiring, training and supervising subordinate staff, acts as liaison to Board of Supervisors, County Administrator and County Departments; provides staff support to the Advisory Committee; represents the Public Authority at the local and state level regarding Public Authority issues; provides input into labor negotiations; and is responsible for compliance with all relevant County, State and Federal laws, regulations and agreements Program Manager Comparable to Under supervision of Executive Director, has Administrative responsibility for day-to-day implementation of Services Assistant III policies and procedures related to the Public Authority IHSS provider registry, provider/consumer training activities and support services; responsible for office management,personnel transactions,and staff support to committees of the Advisory Committee; assists Executive Director with on-going design,development and implementation of Authority services; and supervises subordinate technical and clerical personnel. ! Office Comparable to Clerk Under supervision of Program Manager, oversees Manager/Secretary Senior Level daily office management and operations, including receptionist responsibilities; provides clerical support to Authority staff and Advisory Committee members € and committees; and assists Program Manager with development and review of office policies and procedures. 1 Registry and Comparable to Under supervision of Program Manager, responsible Training Specialists Administrative for day-to-day operation of the provider registry , (2.5 FTE) Analyst including recruitment of providers, provider application and intake, reference checks, provider orientation, provider follow-up, consumer intake, generates provider lists for consumers, referral of providers to consumers and consumer follow-up; provision, coordination and monitoring of provider and consumer training; provision of provider and consumer support services; and overall registry database management. a STAMPT.Fcbmary 20,1999 2 ................................................................ .........................................................................................................................._ ....................... ......_..... ......... ......... ......... ......... .......... .................. .... ......... ......... ......... ......... ..................... ......... ......... ......... ......... ................._ ...... ............_........ APPENDIX S HOW FUNCTIONAL REQUIREMENTS WILL BE MET CONTRA COSTA COUNTY IN-HOME SUPPORTIVE SERVICES PUBLIC AUTHORITY FUNCTIONAL REQUIREMENTS REPORT 1. Assistance to consumers in finding providers through the establishment of a registry of IP providers; and 2. Investigation of the qualifications and background of potential providers. a. Recruits a sufficient number of IHSS providers to meet local consumer needs. b. Prior to placing the prospective provider on the Registry,or prior to supplying a name from the Registry to an applicant for,or consumer of,In-Home Supportive Services the Registry: = Requires Registry applicants to indicate, in writing, whether the applicant has ever been convicted of a crime. • Requires proof of identification from all Registry applicants. Proof of identification includes, but is not limited to, positive photograph identification from a government source. = Interviews all Registry applicants to review their skills, qualifications and background. ■ Checks and documents applicant references. C. Maintains all necessary and required records and Registry and statistical information.. 3. Establishment of a referral system under which potential providers are made known to consumers. a. Public Authority staff makes contact with the consumer (or the consumer referral source)within three(3)working days of the initial contact;or on the same day of the contact in an emergency situation. b. Upon request by the consumer and following completion of a consumer intake the Public Authority refers a list of no fewer than three(3)providers to the consumer. To the greatest extent possible providers on the list match the consumer's stated needs regarding the skills and preferences they require in a provider. C. The list of providers is mailed to the consumer such that they receive the list within five(5) working days of their request; or is communicated to the consumer on the same day as the request is an emergency situation. I d. The Public Authority will not knowingly refer a provider whose background or past work performance indicates that they are not appropriate to be working in the consumer's home. e. The Public Authority does not intrude on the consumer's decisions regarding when or if they choose to call a provider on the list. However, the Public Authority encourages the consumer and attempts to address any particular concerns and/or reluctance the consumer may have concerning the hiring process. Upon request the Public Authority assists in facilitating the process of the consumer hiring a provider. f. In accordance with WIC Section 12341.6,the Public Authority honors the consumer's right to select, terminate and direct the work of any HISS personnel providing services for them. g. Prepares and maintains all necessary and required consumer referral and statistical information. 4. Provide access to training for providers and consumers. a. Provides worker training through provision of on-the-job training, written materials and periodic training sessions. Public Authority invites all HISS providers to training sessions. Training is voluntary and at no cost to the provider. Training materials and the curriculum for provider training sessions are developed in conjunction with the Public Authority Advisory Committee. b. Provides consumer training through provision of written materials and upon request through home visits. Public Authority mails written training materials to all consumers using,the Registry. Training materials and the home visit component for consumer training are developed in conjunction with the Public Authority Advisory Committee. C. Prepares and maintains all necessary and required provider and consumer training and statistical information. 5. Provides the following additional IHSS delivery related functions: a. Acts as an "employer of record" for IHSS providers. ■ Meets and confers with recognized provider employee organization regarding wages, benefits and terms and conditions of employment. • Contracts with recognized IP employee organization for negotiated wages, benefits and terms and conditions of employment. 2 b.. Provides additional support services including, but not necessarily limited to: • Assisting the consumer and provider with understanding employer/employee roles, rights and responsibilities; • Understanding how to interview and hire providers; • Calling providers and setting up interviews; • Being present at interviews; • Conflict resolution; • Developing provider schedules and tracking of provider's hours; ■ Understanding payroll, time sheets and share of cost payments; and • Trouble-shooting payroll and share of cost problems. Cc co functions rpt 2/20/99 3 APPENDIX T CRSS RATE FORIM IN4it" ME SUPPORTIVE SERVICES PROGRAM PUBLIC AUTHORITYINONPROFIT CONSORTIUM RATE To* CaMomis Department of Social Services Adult Serves Branch 744 P Street MS 19.96 Sacramento, CA 95814 Please address queesons regarding this form to Lisa Grec , IHSS Fiscal Analyst, Disability and Adult Programs Division, Adult Services Branch at(916)229-4596. i COUNTY: CONTACT- PA,NAME PHCNB„ ADDRESS: iA NUMBEP: Pleease,complete the budvet narrative below. The total Public Authority(PA)and Nonprofit Consortium(NPC) rate should include a nate for services(eras and benefits)and a rate for administrative costs. The total rate for wages and baneflts should be broken down to include an hourly wage.,payroll taxes, and benefits. o The state and federal governments will not participate in a PA or NPC rate in excess of 2130%of minimum wage. o The state Will not pa to in an hourly wage in excess of minimum wage unless Otherwise provided for in the Annual Budget Act or appropriated by statute. o The state VAN not participate in increases to wages or employment taxes, or increases or expansions of benefits negotiated or agreed to by a PA or NPC uni$ss provided for in the Annual Budget Act or appropriated by statute. o No In !e In wag"or bertefa#s netgottated or agreed to by a PA or NPC shall take effect unto it has been approved by the state or unless provided for in the Annual 5udget Act or appropriated by statute. BUDGET NARRATIVE PAlNPC Hourly Rate: 1 Hourly Administrative Cost: 2 Hourly Services Cost: tow 3 Hourly Wage: 4 Benefits: � Payroli Taxes (FUTA. SU1. PICA.): s Cosztst is(Optional): PUBLIC AUTHORITY/NONPROFIT CONSORTIUM BUDGET NARRATIVE LINE BY L rNF INSTRUCTIONS BOX NUMBERS INSTRUCTIONS I Input the hourly rate. (should equal the sum of boxes 2 and 3) 2 input the hourly administrative cost. 3 Input the hourly services cast. (should equal the sum of boxes 4 through 6) 4 Input the hourly wage. 5 Input the hourly cost for benefits. � 6 input the sum of the hourly rate for payroll takes. APPENDIX U S'TA'TEMENT OF FACTS ROSTER OF PUBLIC AGENCIES FILING CC CO final rpt appendicies 2/20(99 (gray disk) i §#utr of California w tirxa+<atfrcretarrg of ftatr �+ * f I STATEMENT OF FACTS ROSTER OF PUBLIC ..AGENCIES FILING � 3 (Government Code Section 53051) Instructions: ' 1. Complete and mail to: Secretary of State, P.O. Box 94422.5, Sacramento, CA 94244-2250(916) 324.6773 2. A street address must be given as the official mailing address or as the,address of the presiding officer. (Office Use only} s. Complete addresses are required. j ('e 4,.. f you need additional space, please include information on an ! 81. X 11 page. #i New Filing; Update[ 1 i' Legal name of Public Agency: Nature of Update: i County. 3 Official Mailing Address: ,f ! 11 Name and Address of each member of the governing board: � I#� IE Chairman, President or other Presiding Offtctr (Indicate Title): Name; Address: — - - - Secretaa or Clerk (Indicate'Title): I II t Name: Address: t! Name: Address: Name: _ Address: Name- Address: Name: Address: Name: Address. a i Date: 13v: Signature i Typed1tiar,:e and Title Sac/State Form tP/56.406 Flew.4/84 8v S1729 04/19/99 22:07 FAX 5104730700 MAGGIE DEE �t3€31 CLERK of the Board of Supervisors, Ann 0SIDER WITH From: Maggie Dee-Dowling, Resident/Pittsburg Pieria copy this "Opposition"' Report to the Board of Supervisors regarding , "Item, D-4" on the Board of Supervisor's Agenda, today's date and distribute to all Board Members. Thank you. 04/19/99 22:07 FAX 5104730700 MAGGIE DEQ Public Authority, Transltio Team Recommendation RESPONSE OUTLINED: Presenter, Maggie Dee-Dowling, Pittsburg,rg, Consumer Opinion Consumer protections are compromised with Ions of"Employer of Recor&' Maas (Page 5- onsumer Advisory presented in Transition Team's Recommendation is not fuller involved at every .level of the Public Authority and controls are carefully crafted € to Recommendations to make this body ineffectual .1 pages glaring problems exist) Consumers will not be fairly represented on the Advisory Committee, they will be out voted. 8 to fir, should be more consumers on the Advisory Committee that are recommended,suggest 85% with no "professionals"' on the Committee except a Special Needs Desk representative and one Public Authority StafVEx.Dir. and one support clerical with no voting rights, (Page 6-8 -- Need total revamping of both Provider and Consumer softie programs. They are wholly inadequate to meet the needs of the consumer er(Page 3-8 and 7-8) - Minor and major offenses by provider does not protect the consumer enough(Page 7-8 bottom ofpage and Page 8-8) Consumers must NTVE . be forced out of In-Home ;supportive Services, other ways to protect providers Faust be found, an optional state hearing should take place and only the PA's Goven)-ing Board should make the final decision of removing a In-Home Supportive Services client from servicers (Paged'- d -8 Cir of Advisory Committee should take an `'active role"' in Collective Bargaining(page 1 - Communicable disease protection should be a mandate. for both consumers and providers. Heath screening should be mandatory before placing either a consumer in jeopardy or a provider in jeopardy. - Other very important issues are outlined here. Sjjggat, table Item: -4 until both the consumers and other interested parties have a chance to review for more than 65 hours. The transition team had six months to develop this. Consumers have been given a few days to review, - Suggestions have been offered on each,page for each.item 04/19'90 22:07 FAX 5104730700 MAGGIE ]DE. E.- 4004 l ge 2-8, Public Authority,Recomm ndations from'"Transition"ream DWIslon of ResponsibUttles Between en Public Authority ority Staf 'and County Spec4al Needs Desk(SND)-- --the D):.,the A being pr mahly involved in the proAder components of In-HorM Supporfive services and the SNO being primarily involved in ft, consuIrmt components of In-Home Supportive it Is my understanding that the PA is for both the providers and cons .This statament is, either misleading or i'nacc.ErWe. In addition,the consumer's autonomy is qualite"y jeopardized and wftho t the slightest taint of protection r than through the Special Needs Desk persosn i. fir, I will discuss the meed f€ar the 8ND personnel to participate In the PA Advisory Committee itt as a standing Member of the committee f the sofa member kaon the Social Service Department This Is essentlat it Ifideed the 8Ni3 is"Involved in the consurner components�"in-Hors Supportive Services". The PA,Advisory Chair should participate at all of the fbilo ing levels if they are to help design poifcy and proe duras: Obtaining Board approvals - Engage in advocacy activitiesrelated to In-HSupportive Services consumer bargaining process v aminate dies with County ftp-Ho uppontiaSerivices Consult with Social Serv" and other CounV Departments(Item 0-4, 15-3, 5-4, 5-6,and 5.61 The PA,Advisory ChsirtUnion shou€d: make deelsio rs of removal of providers(need cons is vision and protection) Public Authority Staff and Chir of PA Advice should fare consumer inpuk when th6r s is. a difference of opinion the Clair of the PA Advisory should pace e toopposing view to the PA Governing Basal why the PA Advisory Committee does not concur with the pA"s Staff views.Without this, the PA Advisory Committee will not be'advlsoW rather,puppets wfthout any responsibility The development of the Registry,Provider Screening, Referral System, Training and support services for providers and consumers should be done collectively with Me entire PA Advisory Comm (ff$rm 0-4,6-'I) These recommendation do not indicate that ft PA Advftory Committee win be irrvoived In any capacity, There,consumer r pr rnttatk-)n is totally void and consumer protwXons eliminated In this Recommendation segmoot n Recommendation 3,. Adopt proposed recommandadon on division of porral iiiti between the public Authority and Specist Needy Doak: --1 Public Authority Staff provides supportive services if need for services is directly related to consumer/provider Issues,e.g., hiring, firing and supervision of provider,training Suggest: Deftne"related to consumeriprovider issue if training to requested by both the provider and consumer or one of these enth that enter May thous toinot to pwwpata. Hiring g Is done by the consumer,firing Is storm by the consumer and supervision of the provider should ONLY be allowed the consumses peen ion.he€ blic Authority should not assume the p"itlon to direct the consumer In matters of training,hiring or firing unites requested, 34!19/99 22t0e FAX 5104730700 MAGGI DEQ Page ,pubtic Authority, Recommendations from the Transition Team 3-3 Adopt proposed recommendation on annual review of relationship between Public Authority and Special Needs lest€:Suggest that the ISA Advisory Committee part pate In the annual review of the relationship€etween the PA and the SND including consideration of ftcal and funding issues. *Recommendation 4.-Adapt proposed recommendation on plan for ongoing coordination between County In-Rome Supportive Services and Public Authority staff Sug t:The inclusion of the Chair of PA Advisory Committee In any process of coordination bean County In-Horn Supportiva Services and Public Authority staff. A caveat. perhaps repetitive but the PA Advisory Committee should not be" dinated"by the county or the PA.They are'advisaW to the PA Governing Board. Perhaps a Committee of the Board of SupeMsors should be used If there is a need for coordination,The FSA Advisory should have its own c ntrotraupervislon. They are appointed and should be considered able to facilitate their own meetings,have one DSS staff of their choice,clerical support,have a financial consideration to perform t=heir duties as appointed members, not to be treated We men to mesa the state regulation,The ISA Advisory Committee should provide the consumer impart not the County or the PA StaM Suggest that the ISA Governing Body recognize thae autonomy of the PA Advisory Committee, gNe thein full responsibility to facilitate rneefings, inclusion in all County, PA development of policy and procedure meetingswith the purr it r of oc€al rol a,County Cotrrssel, Director of the PA and any other meetings within the county structure related to PA business. One mailing list.„ meeting announcement, calendars of avardWmeatings or activitiles should be ipciusivewhather local, Sacramento or statewide. Historically, meeting have been held without the knouvledgo interested consumers where planning discussion talc p4me,dedains were masde_. this respectfully must stop and inclusion begin with the now PA. The PA Advisorycammittee should have a shared responsibility in providing In-Home Supportive Services with feedback on consumer need& Standards of mnsumarlworker satisfaction surveys should be reported in bods percentages and In reel numbers, This will make the number PA Advisory rr mitte a 1fiendly'. 9-10 and 8.4 REGISTRY IN-TAKE CORM for consumers and providers MUST BE VASTLY Il PROVEDI To use the existing computer program will be ensuring fallure as for wamed when St. Vincent de Paul had the County's contract.. It is who!j Inadequate and[ad to St.Vincent de Z"s failure to provide adequate aessistan to s su rs.The PA Advisory Committee should e recommendations r pmgra ages. Intake Infortnation and surveys should be computerhted NOT DONE ON PAPER which can be easily destroyed. Information in a database is harder to delete Computerization will mrd easy access to data needed the PA Adv Committee for report preparation and tracking detawhich will to helpful to their role as'advfqoWe The PA Advisory should decide by consensus how they can moat effetely advise the Board of Super isoWPA Governing Body and oar their recommendations to the Goveming Body for approval There is a need for an outside independent source to be the In-Home Supportive Services nsurs des ombudsman, SUGGEST,Protection and Advocacy,they know the Welfare and Institution Code and wholly represent the v4mumar. This should not be addressed in-house. It will be to the detriment of the consumer and problem wilt not get resolved, M07 FAT, AGI.E, ra04/19/99 5104730700 y Page 4-8, Public A t city, Response to Transition Team Recommendations Recommendation 5,Adopt proposed recommendation on Board of Supervisors toles and responsibilities Suggest That the top three oandidatees selected for the position sof the PA Executive Dior he Interviewed by the PA.Advisory Committee and that the PA Advisory Committee advance theIr recommendations to the PA 0overning Board. Advice from the PA Advisory Cs mmli s should be sought when developing g policy direction relative to collective bargaining activfflas. Suggest that the Chair of the PA Advisory tales an active role in the process based on his/her°direction from the S of Supervisors and the advisory helshe heads(mots; this Is done suocessfulty In Alameda County. It is Interesting that Cern"Costa County does not took to Alameda County's fbtma,'tion, policies and procedures...but clearly timet seems to be based on the consumes high visibility and conte over the programs that ensures their Independence.The other counties held up for example have a rimy control and directives mandated to control the consumers in advisory capasjty The PA Advisory Committee should be given a coley of proposed budgets to review. Oftn stipends stay the same.Stipends should be,based on the activity of the Advisory Committee members and,peau support staff needs. -2, 'theCounty's Administrator should NOT facilitate comrrfuftation between the PA Staff, Advisory and Board of supervisor `PA Governing Body, This is again,conbvifing the Advisory Committee. Perhaps a means ibr facilitation should carr f rrr one of the Beard of Supervisor's Committees. The PA Advisory Committee should not be bound to the dies sof the County Administrator.The "organizations Charf found in Item does not indicate any connection to ft Advisory, nor should it. 5-3,b) Social Service rcpt:regarding Public Au taority staff*and the Inclusion of the Ad*soty Committee on educational and Informational activities, consultation and participation. 6-6,Suggest that Human Relations Department instruct Advisory Committee,on labor negotiations standards and practices so Advisory Committee members know bow to use this channai and the Chair can Participate ao ciy Suggest that Risk Management and County Counsel design for both the ptovider and consumer what protections are available to the end user and those who serve Uis end reser: Recommendation ,'Values Statement.AND Adoption of proposed wommadations on Public Ata#ho ty Statement of Duties Strongly suggest that the PA Advisory develop or adopt or amend t "Values SUtemanC in concert withprovider representation and cue to a full consensus -t,2e Suggest change frown; "...consumer should have assistance in locating arra nmintsin their relationship with ins Home Supportive Services Provider..." to, "if consumer requests assistance in locating and/or maintaining hair relationship with In- Home SuppoMve Services provideran 04/1.9/90 22:07 FAX 5104730700 MAGGIE DEE Page , PuVic Authority. Response to`transition Team's Reoommendalions - . Mission Statement Should be tabled until the P.A.Advisory sweets so that the Advisory members can participates in the design of they PA Mesion Statement or ft adopWtv as suggest by the Transition Team- 6-2,This statement should be In four sentences each with Its own component 6-3,Employer of Record, If the consumer is no longer the"Employer of RK what cont does the consumer have in the Unemployment Senefits when the employee refute to work, does not report for work or worse is abusive sexually or physically.What protection does the consumer have to pis charges when they are no lamer the'Employer of Record'then the "provider'is Insulated from irnmedlats charges and the consumer loses fir protection. It is essential to leaves they OEmpkr year sof Record"an the nsu is hands.6-2 points out that the ,Employer of Rewrcr must be in the hands of the PA for purposes cat"collective bargaining over wages, benefits and teams and conditions of er pfoyrnenV By the consumer keeping the `al_rnployer of Rem staters they can deal more effee0vely with Employment Development Depwt pant when they have a provider whey is nOt P060tming their assigned duties or negligent In their performance of duties.` hes consumer what tIttle p atocbO w they hWvW ,16-3,Omission of'Advance Payment Program"IP consurnam(6 In Contra CostsCounty due to the lack of ttars c ourity`s'misinformation.) Erroneous Information has been given to consu". rs who inquire about Wvance Payments"by Contra Cosa County Social Service Department, When inquires con-to in abort the Advance payment program, interested people are told that they must,cafoulate all withholdings and*.axes which Is nest factual. The psyroil contractor can do one of two things: Give t.he percentages used by payroll to figures out the withholdings OR A person can ask for assistance from payraft to calculate Gross and Not payments it a"farnfly provldee wants to be paid in rAdvance Paymerif then thay get one check at the beginning of the month. Checks can be deposited into a separate aunt as a Direct Deposit. That amount Is automatically they"Nei'figure as payr&3 sends by Direct Deposit ONLY the net amount aftr the vErit"Aoldings.The money can be drawn down each two weeks. Providers must have their State and Federal taxes done or prepare them for themselves. In-Home Supportive Services Payroll does:not provide state and leder t w ithh ldings because of the"Employer of Record'status. If the PA controls the payroll and withholds the state and federal taxes this may be a benefit for some people but not all.The'Employer of RecoW should be an optional issue when a pw,son Is riving Advance Payment. It is my belief that if the payroll is put into the hands of the Public Authority Individual choice for union dues or contributions to a 501 (c)(3)Is seriously jeopardized. This issue must come with a direction from the public Authority Governing Body while these controls can still be exercised at the adoption process Is actively being reviewed. 6-3,5. PA Statement of Duties, ProvWe training for providers and consumers. Suggeston 11for change to:'Provide training for providers and of requested to consumers.Consumers should not be required to take training. ,6 PA Statement of Duties.. Provide or refer to supportive service that assist in assuring a sup c ssftrl,productive and accountable relationship between the consumer and provider. Suggest change: Ariake optional support services that will mist in assuring a successful, productive relationship between the consumer and provider. 22:0 FAX t04730700 Testimony before the Bard of Supervisors April 20, ,,999 by Facsimile and Phone irk-l-?csme Supportive Services/Pubiic Authority-Contra Costa County ITEM, D-4 My name for the record is, Margaret Dowling, f live at 426 W I11�'Stree,Pittsburg,Ck t am ars in-Home up rtiv Services Consumer. The TransiUon Team spent 6 months developing the Racxarrsr and2tlOng Which you have before you today. i ijave had ore weekend to review and comment on this de rrne nt. €am requesting that t.The;points outlined tar,these subnnitted pages remive a Witten response from the Public Autfso6V Governing Board in concert with the Lae# rfnWrat Of Social Sem ; 2. 'fiat the submitted issues outlined Wow are considered by the Board of Supervisom beftwe any decisions are made on iter rr 0-4 belom you today or that these issuers are forwarded to a&xvd of Supervisor's committee for further study and development RECOMMENDATION 1,Adopt proposed recommendation on Public Authority Staff roles and responsibilities Suggest that the Clair of ffie Public.Authority(PA)Advisory Committee and the Executive Dire&or of ft PA,act as liaisons j in;iy to ft PA Governing Body, hoard of Supervisors,County Adm lstrator-,county cos_rnsei and all other Counly Departments(Mom 0-4, , -4, 5-5,5-6) and offend til and,Mate level meetings and actIvIties. The Chair,a consumer, of Me PA Advice is a responsible position to which the person should to elected by the Advice Committee and should be given by the F'r`y Governing Body the responsibilities to participate at all iaysis.A stipend should be considered obligatory and mil travel expenses should be paid. (Seep Item 04,6-1) The Chair of the PA Advisory,a consumer, should take ars active role in the collective bargaining press after reaching a consensus of the fulf Advisory committee. (See Item -4,6_1)This is dome successfully in Alar- da County,An advance perimeter agreement drawn sip by SEW, .Alameda County's Counsel, the Advisory Committee and the Etcecuttva Director of the Pubfic Autl°oMy.The consumers insisted that tb . participate,actively.The force of outside legal malpresentation was pursued but not used w6an all partles reached an agreement it was reed that the Public Authority concept is new and a ground bask€rag nv#tYod to deliver ln4i Supportive Service through'equal representation of consumer and provider du g tho cchhh0+a bargaining process'. The Human Relations Department oared a training element to the Advisory an Collective Bargaining pracrice. The Cheir of the Public Authority should help the Executive Director in the development of decisions regarding blearing appeals far•rernoval of providers Recommendation 2,Division of Responsibilities. Dtvwon of responsibilities between County In-Home Supportive Services and Public Autl'ro tjr county in-Homo Supportive services Public Authority Staff ADD: PA Advisory should pride#ts own consumer input,not the"staff of the PA". 22.0 �FAX 510473070 AIE T3 04/10/99 u.: EE Page 6-8, Public Authority, Response to Transition Team Recommendations Chapter 4,Reemmendation I Adopt proposed recommendation mendation that the a rote of the Advisory Committee to to serve in ars advisory cap&cW to the PA and Governing Board and to tie Public Authority Staff THIS SMACKS OF CONTROL I, The Advisory Committee should develop their own fission Slatemend , The Advisory Committee should develop their-own"primary'role and present this to the Governing Board 3. The Advisory should not be shackled to"Input'rather than seeing their recommendations opted, 4, The Advisory Oommittee should NOT have to go through the County Administrators of ce regarding ading legislation that may impact the in-Home Supportive s program, consurners,providers and/or Public Authorii ,The Advisory should review,advise and make recommendations to the Governing Board via the Committee's Chain arra offer a courtesy to the PA staff,the County's leg'-dative staff,THIS i CONTROLLING and unnscamryl S. N "irrpur into€ llective bargaining rather taking an ACTWE ROLE IN THE COLLECTIVE BARGAINING ININ pRO ESSi PA Advisory Committee should sat the me standards,Jnr€th the PAS Governing rd's review and approval£that a provider can be removed from the registry. it there is a danger to consumers a long process Zvi€lioould endanger other consumers or the consumer 1br whom they worked. Co lel�fz3 - 86 percent of the membership should be consumers r"sentative of varying needs for In- Home:supportive Services and d l`4`es,50 percent of the membership should be'current" users.Of that 50 percent the major disabilities should be represented: The til€nd(blind-cleats mobility, profoundly developmentally"abled.om member m th a faniiy member provider, too members with;a minimum of 150 personal care hours,one member on OAdvance Payment program'and one member should be a rural representative and orae nmmber an urban representative. If a�pdvata pay"member fs absolutely necessary the should have a minimum of 160 hours of personal care and 3 mal planning,and meal preparation. 16 percent should represent"domestic, laundry,shopping errands only consurna . Reasons for this: Unless your neads for high-level care is an aituatity you can not understand the necessity for trained provides and a well organized and operational PA. In Alameda County€host of the Advisory are pro5oundly disabled yet think globally for alt levels of to-Horne Supportive Services needs, Diversity of ethnic,cultural etc Is secondary as the needs of those who use tet-biome. Supportive Services: In the adoption of tete recommendations it can be a cls charge that all decisions must be based on a consideration of ethnic and cultural issues,To assure this, decisions can be reviewed by the Human relations Department for bias protection. 00 NOT AGREE TO THE REPRESENTATIVE Qp In-Home Supportive Services CASE LOADI lorrrtula. Pose see the:above suggr tons. 8 Consumers and 8"other Conirnittee Members. rho constimers wift not h&ve r= over tho PA Adv1sary . orvanhation adVocate.nqjUft%NW r_ unger,dF. This is outrageousl A pointronts should be In segments of two years and one year to allow for steMeting, memberships.A.one year terms csn be tended th€ ugh a renewal process and a two year term moves out.A four year committrnent for a person with a disability is not arrays feasible due to progressive disability issues and wurprise changes in a person's health as a result of their disability or the unexpected,. S# e I C $ 22:07 FAX 5104}'30700 MAGGIE DEE �14� Page 7-8, Public Authority, Response to Transition Team's Recommendations Sagest that the PA Advisory Co#'rnitteae meet on a rotation basis in all three sectionb of the County. Each quarter tee, East,West and Central giving oonsurners an opportunity to visit the . PA Advisory Committee meetings for personalized input rather than depending on xres�sre3sea rttivca`n -4 Adopt proposed recommendation that the Reg)stFyease registry software and forms previously developed by the County. NO? They are avholty inadequate, misleading Information or no information AT ALL that the consumer can use. The Advisory Committee t with the assistance of the Special Needs plc personnel should set the computer fields for ussable questions for both the provider experiences and consumer meads. Regietty Operations and Policies and 12mcedures Criminal Background d checks should be. openly offered to,ALL consumers,the fee for background checks, where to get assistance for criminal background check,what to expect after a background nd check is comploften a criminal background check can be done,who gets the report,the advantages and disadvantages. 9-2, _ Providing proof of valid driver's license and current insurance should be facilitated by the PA!An update of both should be kept In the:Proariders file and assurance that alts was check by the PA staff before sending someone out to a consumer that needs someone to drive therm to Moes appointments,arrands,shopping etc. The Implernentation Team's recommendation jeopard the consumer and the PA concept and practices. Imagine someone who Is mentally impaired or gnitive)y disabled or blind taking an this task. g-1, How can work references provide any sound information when the law prevents employers from giving out anything but date of employment,We must fired a way to work mom closet with the provider In obtaining work-related Information. 9-6 Communicable diseases and drug testing should be tested BEFORE sending a pr der out to a vun-erable population. This is done by every major employer.This should be paid for by the heaft beneflt the provider will get if employed BEFORE first day of work and results road before fiat clay of work. Providers must be told that an In-Home Supportive Services recipient has a communicable disease;and careful training MUST be offered BEFORE going to client's h€mei Both providers and consumers MUST BE PROTECTED[ ",Add, In concert with the Public Authority the Advisory Committee develop a General Policy on removing a provider from the,Registry, develop reasonable rules and regulations regarding the appointment to and remove of provides from the Registry UNDER NO CIRCUMSTANCES should a persr niconuumer be removed from the program without a full Investigation, an appointed ombudsman Or a tOPPOSOntathIS of the COnWnVes choice or an attorney of the consurn r`s choice representing the threatened consumes. Every avenue of referral to help icor the consumer MUST BE used and a State Hearing must be requested so that a hearing officer will make the final decision. The decision should be the € overning Boards foal decision after reviewing all the facts and taking any additional comments from theconsumer's side, for ae� r �fas�rss raf v A erf after 04/19/99 22:07 FAX 5104730700 MA 1E DUE 4010 Page 8-8, Public Authority, Response to Transition Teams Recommendations One year should be the limit for two minor inins. The policy development on tasues of 'minor infr tions" and'major Infractions'should be developed with the Advisory Commlitee Ail complaints should be reviewed by the Public Authoifty AND the Advisory Committee,All complaints "srauid be stored In the computer databose and shared iMth any mer PA if the provider rues to ensure that their treatment of consumers was questionable in CCCo. -10 NO PAPER...elf Intake rearms Wriould be computerized into a data base for statistical purposes,tracking,reporting and follow-up! 9-10,time frame for infoffnet on to consumer MUST beshortened ftr those wbo are profound disabled and reed s provider i medieteiy,An emergency program for backup providers MUST be designed for time who are bedridden or have difliculty getting out of bed or need protege supervision. 9-11,All providem must be checked BEFORE sendIng out a list to consumers!No protecton ftr the consumer offxf wise!Navy of the prey ders list of-town and out-of-state l r .Tf is oost should not be borne by the cons sr rt 9-14 NO paper surveys ONLY COMPUTER DATA BASE to track.This should be e jointeftrt to design the program 9-14 Support Services should be optionai 9-15, NO consumers excluded from the PA setvicas,They can be asked to have a With"m or that someone of their cholos supervise Ira-Home Supportive Services services....but NO EXCLUSION1 Prepared by Maggie Doe-Dowling, Immediate Pam President CA Democrats with 0 Rias Fax Transmittal Guyer Sheet CONMER WITH To: Honorable Clerk of the Board, ff++1r. Joe Canciamilla, - Board of Supervisors From: Ruth Fontana, Fax Phone Number: 925-691-7884 Date: Tue, Apr 20, '1999 • 8:37 AM Transmitting (8) pages, including cover sheet. If here is difficulty with this transmission, please call: 925-691-7884 Note: -925-691-7884-Created-Tuesday, Apr i t 20, 1999 8.37 AM- page 1 of 7 -------------------------------------------------------------------------------------- Honorable Board of Supervisors: 4/19/99 Thank you for allowing me this time to express my concerns about the recommendations of the IHSS Task Force presented to .lour~; Cullen, So- cial Services Director, for the Implementation of the IHSS Public Authori- ty. I would first like to say that I am not Happy that I was given a wee- kend to review a report that well, working people took 6 months to pre- pare. I called in my request for this report to Mr. Elden Luce on March 25th. It arrived April 16th. I will do my best to address my concerns. As an overview, the report is lacking consumer protection. There's no provision for an advocate or ombudsman. The Public Authority Imple- mentation Team is lacking in consumer participation. The implementation team seemed to have only 3 consumers. The Public Authority was designed to protect the consumer's rights, yet reading this plan, you'd never know that. Also, throughout, there are references to an old computer program to be used. This program includes a form to be filled out by providers listing what conditions they are willing to, or have experience working with. The farm is confusing and III-conceived. Being a person disabled by MCS, I'm grateful that it has questions regarding the use of fragrances and cigar- ettes, but the form stops there! It doesn't ask any questions about work- ing with the physically challenged, the mentally challenged, the visually Impaired, or any other physical or mental disabilities. Many consumers have multiple disabilities, by the way. The program MUST be rewritten with all disabilities in mind. The report speaks of a Steering Committee, but it doesn't state who is on this committee. Recommendation #1, page 4. bullets 8,8,9 and 10 should include at least the chair of the consumer advisory. This shows a lack of consumer participation, and therefore protection In favor of the county and SEIU. Recommendation #2, page 5 also lacks consumer participation. Recommendation #5-1, page 7, bullet #1,5,8 also lack consumer ad- visory. 925-691-7884-Created:Tuesday, Apri# 20, 1999 $;3T AM - mage 2 of T -------------------------------------------------------------------------------------- Recommendation #5-4, page 9, bullet #2 doesn't state to whom the services are provided. Bullet #3 should include the Consumer Advisory in the decision making process. Recommendation 7-3, page 14, V. The chair of the consumer Advi- sory must be part of the collective-bargaining process. Recommendation 7-4, pages 14 The Advisory Committee membership must be made up of ONLY IHSS recipients, not private pay consumers. It should include a: consumer contracted to at least 150-200 hours of IHSS, a person disabled by MCS multiple chemical sensitivities, a person who is blind, and ethers of differing disabilities for a well-rounded and fair Ad- visory Committee. The `diversities' stated in the proposal aren't import- ant here, it Is the disability diversity that matters for the committee. Recommendation 7-4., page 15, #1,a,d The consumer members must be IHSS recipients with knowledge of living in poverty. And, the number must be 3 disabled and 3 seniors, and at least one consumer should be us- ing 150-233 IHSS hours, not by percentage. Recommendation 7-4., page 15, 16,#2,a,c,d These positrons must be filled by past or present recipients of IHSS hours, not private: pay. Having the Supervisors choose members from a list is not acceptable. And d) is a contradiction of the other recommendations. The list of recommended Ad- visory Committee member categories proposes an 8-1 ratio, which unfa- vorable to the consumer. Recommendation 7-4., page 16, #3, bullet #1 again speaks of divers- ity when the consideration must be disabilities. Recommendation 7-4, page 16, #5 States a term of membership of 4 years. This is unacceptable for people suffering disabilities, and should be limited to 1-2 years maximum terms. Chapter 5, page 17 Registry Design is unacceptable. The registry should be contracted out and It should not serve private pay consumers. Recommendation 8-1, page 17 1 don't agree with this recommenda- tion as it wouldn't protect the consumer. - 928--601-788 € -Created.Tuesday, April 20, 1999 8.37 AM- Page 3 of 7 -------------------------------------------------------------------------------------- Recommendation 8-4, page 18 NO. This would reuse a form which is wholly inadequate for the needs of consumers! A new form MUST be for- mulated with Input from recipients and providers. Registry Operations and Policies and Procedures The section on background and reference checks must be optional for consumers. This will be a financial burden to consumers and many already know their pro- dder well. Recommendation 9, page 19, #1,2 Recruitment of providers must also meet the needs of the varying disabilities, such as MCS multiple chemical sensitivities (no fragrances, or chemicals), etc. The caution statement is ridiculous! Recommendation 9, page 19 #1,3 Providers should be listed by clas- sification of their job preferences. #1. Back up provider, #2 On call pro- vider, #3 Past time provider, #4 Full time provider, #5 Full time + extra, hours provider. The outreach suggestions could be expanded and must in- clude the Department of Rehab, and Senior Employment Services, for ex- ample. Recommendation 9, page 20, #2 bullet #1 The old computer program for the application is useless and should be abandoned and a new one rede- veloped by the Advisory Committee. Recommendation 9-2, page 20, Provider Intake Process policy. The intake process should be optional, especially for consumers with longtime providers, etc. The intake provisions shouldn't be so strict as to deter consumer/provider use. Many provisions should be optional. Recommendation 9-2 Intake Process, #4 When requiring a particip- ant to sign the signature page of the Provider Handbook, someone must be sure the participant actually speaks the language of the handbook and can Indeed read and comprehend It. If they don't, someone must offer assis- tance. Without everyone understanding this, the process is useless. Recommendation 9-2 Intake process, #5 A criminal background check should only be required it requested by the consumer. Recommendation 9-2, page 21,Intake Process, #8 A copy of these - 925-691-7884-Created:Tuesday, Apri€ 20, 1999 8:37 AM - Page 4 of 7 training documentIcertificates should be giver'; to the consumer, as well. Recommendation 9-4, page 23, Procedure #5 This list should in- clude a minimum of 3-5 providers who have had background checks per- formed. Recommendation 9-4, page 23, Procedure #8, bullet #1 Having the provider fill out such recommendations supposes they are doing it without fear of retaliation from the provider. This could be misleading putting following recipients at risk and should be optional for the consumer. Recommendation 9-5, page 24, Interview/orientation #2, bullet #2 Again, the provider must be able to read and understand. They might be asked to read the page allowed for verification of ability. Recommendation 9-5, page 24, Interview/orientation #2, bullet #3 Now were these rights and responsibilities developed? And, by whom? Recommendation 9-5, page 24, Interview/orientation #3 The Pro- vider Handbook This book needs to include information on what consti- tutes quitting, laying off, and firing of a provider. Consumers also must be informed what they may, or may not ask a recipient, by law, during the interview process. Recommendation 9-8, page 24, 25, bullet #1 When working with vulnerable papulation, NOT to place communicable disease testing at the top of the list is irresponsible. Vesting should include: TB, AIDS, hepatitis B&C, syphilis and herpes at MINIMI-1M Recommendation 9-7, page 25, Policy Monthly reporting would be more reasonable than every two weeks. Recommendation 9-8, page 28, General Policy These committees must Include the Advisory Committee. Recommendation 9-8, page 26, Policy-Minor Offenses This must also include the Advisory Committee. Also this should be only a one year period, not two. Recommendation 9-8, page 27, Policy-Major Offenses This must - 925-691-7884-Greeted.Tuesday, Apri 1 20, 1999 8:37 AM - Page S of 7 --------------------------------------------------------------------------------------- also include the Advisory Committee and must include offenses that put recipients at risk, such as smoking on the premises without permission, or using chemicals or chemical fragrances when the recipient Is allergic, or requesting/requiring consumer to pad the hours. Recommendation 9-8, page 27, Policy-Major Offenses, bullet#10 This offense must be defined and Include background. Recommendation 9-8, page 27, Procedure Must include the Advisory Committee in these evaluation and complaint processes. Also, the two year period must be no longer than one year. Recommendation 9-8, page 28, Appeal Process What IS the advisory rules for appeal? ,And, any physical or sexual assault MUST be referred to the District Attorney for prosecution. Recommendation 9-8, page 28, Appeal Process, #3 Appeals must be accepted In writing OR In person, If better for the consumer. Recommendation 9-8, page 28, Appeal Process, #4 I don't under- stand this provision. Mutual consent of who? Recommendation 9-9, page 28, 29 Procedure, #1 Evaluation must include the Advisory Committee. Use of computers would make this pro- cess quicker. The consumer should be contacted within 2 working days and the process could be instantaneous with computers. Consumers are at risk If left 3 days. Recommendation 9-10, page 29, Policy Computer Intake would be quicker for the consumer. Recommendation 9-10, page 29, 30, Policy, #'1 Again, the number of days must be 2 not 3. #4 Intake must be done by computer to facilitate a quicker outcome for the consumer. This would allow for a list to the con- sumer Immediately and a turnaround of 3 working days by mail. #6 This is the ONLY consumer protection offered In the entire document. Verbal, fax, or small responses must be allowed, especially for consumers In emer- g+encles. There must be care to balance the rights of the provider and the consumers - 925-691-T884-Crested.Tuesday,Apr 11 2€1, 1999 8:37 AM - Page 6 of 7 -------------------------------------------------------------------------------------- Recommendation 9-11, page 31, procedure, #3 The consumer should be given a minimum of 6 providers and the maximum should be endless un- til a provider is found. Recommendation 9-11, page 31, Procedure, #7 The consumer should be informed of any background check results, and how to fallow up the driver's license and Insurance search, If necessary. Recommendation 9-11, page 31, Procedure, #8 The -consumer must be aware of the definitions of what is reasonable to request of the pro- vider. Example, Does the provider assist with preparations for a Section 9 inspection? Recommendation 9-12, page 32, Policy The number of referrals Is too low. Minimum should be providers. Recommendation 9-12, page 32, 1, c Procedure Previously, the procedure specifies in writing...now says by phone. Should be both, not one or they ether. Recommendation 9-12, page 32, #1, d Procedure Screening has al- ways been stressed as a consumer MUST. And, the cost MUST fall to the provider. Recommendation 9-14, page 34 ANY survey should be optional. ARE STATISTICS BEING KEPT? WHERE? WHO MAY VIEW? Recommendation 9-14, page 34, Policy Follow up time frames of 19 days would put the consumer at risk, depending on their frailty. Shorter follow up should be Implemented for frail consumers. Recommendation 9-14, page 35, #2 procedure Additional support services should be optional. Recommendation 9-14, page 35, #2, bullet #9 Any consumer MUST have access to the Special Needs Desk. Recommendation 9-14, page 35, #6 This provision should be option- al and should be on computer, as 1s the intake form. - 925-691-7834 -Crested:Tuesday, April 20, 1999 8c37 AM - Page 'r of 7 --------------------------------------------------------------------------------------- Recommendation 9-14, page 35, #7 This is duplicate. Recommendation 9-15, page 35 Exclusion of consumers could be discrimination. They should be offered Delp for their problems, first. Chapter Six, Findings and recommendations How many consumers attended these crucial forums where policies were made? Why wasn't the more 'consumer friendly' Alameda County Public Authority considered a model? Now many people were involved on the Steering Committee? Recommendation 10, page 37, bullet #'2 This should not be a man- date. The sentence should end at 'upon request'. Determination of Author- ity staff is inappropriate. Recommendation 10, page 37, bullets #5-9 Services should be of- fered as optional and only on request. Consumer and Provider Training Who will pay the consumer's cost of transportation? Training should be at the request of the consumer. Recommendation 11, page 38, Policy Consumers should not be man- dated for training and `determination of need by Public Authority staff' is unnecessary. "A stipend will be pain to unroll Co Co Co IHSS providers..." Stipend MUST be paid to consumers, as well. Recommendation 11, page 38, Procedure-Consumer Training SHOULD BE CONSUMER'S OPTION. What about homebound clients, and chemically sensitive clients? Should Include training for physical thera- py, occupational therapy, and other needed paramedical issues. Chapter Seven, page 40 There appears to have been no consumer or Advisory Committee input here. Thank you again for allowing me the time to comment on this report. I do hope you will implement changes that will provide for more consumer input and protection. Sincerely, Rath Fontana, 1544 Bailey Rd., #1, Concord, CA, 94521 925-691-7884 .0, � To. BOARD OF SUPERVISORS Contra FROM: John Cullen,Director ..`*� ;• Costa Social Service Department ounty DATE: April 7, 1999 .r SUBJECT: IN-HOME SUPPOR'TI'VE SERVICE(IHSS)PUBLIC AUTHORITY SPECIFIC REOUEST(S)OR ASCOMMENDAtION(S)&BACKGROUND AND JUSTIFICATION BFCMOMMATIONS` 1) ACCEPT the attached report entitled. Findings-and der mm d tty submitted by the In-Home Supportive Services (IHSS) Public Authority Implementation Team to the Social Service Director in March, 1999. 2) ADOPT the forty-eight(48)recommendations in the attached report,including four(4) additions made by the Social Service Director, (The additions offered by the Director are summarized in Background/Reasons for Recommendations.) 3) AUTHORIZE.the County Administrator and Social Service Director to begin recruitment, hiring and location processes for the Public Authority staff, who in turn will operationalize the Public Authority based on the Implementation'Team Report, 4) DELEGATE the Aging and Adult Services Director(or the Social Service Director if that position has not yet been filled) responsibility for the supervision of the Executive Director of the IHSS Public Authority. (The Implementation Committee provided four options for reporting structure for the Director's consideration.) 5) ACKNOWLEDGE the hard work and perseverance of the twenty-seven individuals who participated as members of the Public Authority Implementation Team and thank them for their contribution to the establishment of the Public Authority. In accordance with the Board Order adopted March 10, 1998,following the issuance of a Request for Proposals, CONTINUED ON ATTACHMENT: 2L—YES SIGNATURE. ...._RECOMMENDATION OF COUNTY ADMINISTRATOR .o,.e_RECOMMENDATION OF BOARD COMMITTEE APPROVE . .OTHER ACTION OF BOARD ON TDr11APPROVED AS RECOMMENDED oTHER See Addend= for Board action. VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE UNANIMO S ABBE_- AND CORRECT COPY OF AN ACTION TAKEN AYES: - NOES: nn AND ENTERED ON THE MINUTES OF THE BOARD ASSENTt 'pQ'�•}(, --..._.._ -ABBTAIN: I"T �� OF SI3PERVISORS ON THE DATE SHOWN. CC ATTESTED I�T�r i_1 70 _19M_ PHIL BATCHCLOR,CLERK of THE BOARD OF SUPERVISORS AND COUNTY ADMtN:STRATOR M382 110/88) BY ,DEPUTY the Social Service Director retained the services of implementation consultant, Eldon E. Luce, to assist the County in establishing the Contra Costa County In-Home Supportive Services(IHSS)Public Authority, Mr. Luce served as facilitator of a 27-member ad hoc Implementation Team appointed by the Social Service Director. Implementation Team members represented a cross-section of major stakeholders in the IHSS Program. The Implementation Team convened for its first meeting on September 3, 1998, and met twice monthly thereafter,completing its work on March 4, 1999. Mr.Luce submitted the Findings and Recommendations of the Implementation Team to the Social Service Director on March 7, 1999. The recommendations are the product of the diversity of knowledge represented by Implementation Team members,technical assistance from other Public Authorities, and input gathered from three community forums. Understandably, the recommendations in the report are the product of consensus among members of the Implementation Team. The report is well organized into six general areas and provides a great deal of group thought and findings that will expedite our implementation. These areas include: 1) Public Authority Role, Responsibilities, Relationship, and Level of Coordination with Other Entities; 2) Public Authority Values,Mission Statement,and Duties; 3) Public Authority Advisory Committee Role,Mission,Duties and Membership; 4) Public Authority Registry Design,Operations,and Policies and Procedures; 5) Consumer and Provider Support Services and Training; 6) Public Authority Executive Director Reporting Structure, Staff Positions, Job Descriptions, Salaries and Benefits, Performance Measures, Office Space, Budget, Rate, and Documentation Required by the California Department of Social Services. following review of the Findings and Recommendations,the Social Service Director has made additions to four of the forty-eight recommendations made by the Implementation Team as noted below and specified in the report by italics. The four additions offered by the Director include: 1) Provision of an example of case management functions as part of Recommendation 2,page 5; 2) Clarification that the Advisory Committee will focus on Public Authority operations and will work through the County's legislative staff when offering advice on pending legislation within Recommendation 7,page 14; 3) Making provision for the duration and staggering of Advisory Committee membership in Recommendation 7,page 16;and 4) Incorporation of the Team's performance measures for the Public Authority into the interagency agreement in Recommendation 14,page 46. In addition to these amendments,the Social Service Director was asked to recommend one of four options for the organizational structure/reporting responsibility of the Public Authority. The options presented by the implementation'Team, include direct supervision by the Board of Supervisors as Public Authority Governing Board; reporting to a Committee of the Board;reporting to the County Administrator;or reporting to the Social Service Department. Pros and cons for each of these has been listed by the Team on pages 44 to 43. Oven the need to maintain extremely close coordination/cooperation between the Public Authority and Social Service Department components of IHSS, as well as fiscal and programmatic accountability vested in Social Service Department, and the vital role of IHSS within our County's long-term care planning effort, supervision of Public Authority staff by the Department is warranted. JSC:sjb