In-Home Supportive Services Reform

About the Program

Category: Human Services (Best in Category)

Year: 2011

In-Home Supportive Services (IHSS) is a state-mandated program administered by counties. IHSS provides an alternative to out-of-home care for low-income seniors and persons with disabilities. The program is funded, in part, by the County with funds that could be used to other critical safety net programs serving vulnerable seniors and children. Costs have increase significantly (9 percent/year) during the past ten years – an issue of great concern to the County Board of Supervisors and administrators. In addition to concerns about IHSS skyrocketing costs, the Board also expressed concerns about program integrity, fraud prevention and other flaws in the program. In March 2009, the Board directed the County’s CAO to develop an IHSS reform proposal. Staff embarked on a huge effort to develop an IHSS reform proposal, with input from numerous stakeholder groups in the community. After this broad program review, a number of recommendations for reform were adopted by the Board. With the implementation of program changes, costs associated with program growth were reduced to 4 percent last year, with an anticipated cost growth of .32 percent this year. As a result of this reform effort, the County expects to spend $25 million less than anticipated for the program in FY 2010-11.