In-Home Supportive Services Update
* Second Quality Assurance Stakeholder Meeting 1/25/05
* Guidelines To Counties On IHSS Independence Plus Waiver Due

SACRAMENTO  -  The Department of Social Services, which oversees the In-Home Supportive Services (IHSS) program that serves over 300,000 children and adults with developmental and other disabilities and seniors has scheduled for January 25, 2005 (Tuesday morning) a second meeting in Sacramento of interested organizations, advocates and others on the implementation of a "Quality Assurance Program" that was mandated as part of the State Budget-related bills passed last July.  The Department of Social Services held the first such meeting on October 18 in Sacramento.  Gov. Arnold Schwarzenegger's proposed budget for 2005-2006, that he will release on January 10, could include additional proposals or savings to IHSS  that could impact the IHSS Quality Assurance program.

Quality Assurance is an on-going permanent component of the IHSS program and will also include a complete review with advocacy organizations and individuals of all state regulations related to In-Home Supportive Services with recommendations for changes - a process that could take several months or longer.
The Quality Assurance program doesn't directly impact IHSS worker wages or eliminate any programs - issues that were of major concern to advocates during the budget battle this past year, but it will impact in some way how IHSS services are
delivered through making changes in how hours are assessed, and standardizing many parts of the program, including training.

In-Home Supportive Services is a state-administered, county-run program serving eligible seniors, the Blind, and children and adults with developmental and other disabilities who are unable to perform certain services for themselves and who could not remain safely in their own homes without these services

Guidelines & Information for Counties on IHSS Independence Plus Program
In addition, guidelines and information for all California counties on the implementation of the IHSS "Independence Plus" Waiver were supposed to be released last month and are still pending. The "Independence Plus" program waives or provides an exception to federal Medicaid rules that allow for federal matching funds to support services under what was previously known as the state funded only IHSS "Residual Program", that Gov. Arnold Schwarzenegger proposed for elimination last year.   Schwarzenegger later rescinded his proposal in late April and asked the federal government for matching funds, which was approved in August.

The IHSS "Independence Plus" waiver was effective as of July 1, with no changes in eligibility or benefits.  About 75,000 people receive services under this program.

Among the services the "Residual Program" offers is permitting a parent of a minor child with developmental or other disabilities, or the spouse of a loved one with disabilities (or senior) to be their IHSS worker, under stricit eligibility standards.  Some advocates, including those in San Mateo county and elsewhere however claimed that some county workers still did not realize that the IHSS "residual program" was now a  federal Medicaid funded program. Some of those advocates claimed that the county denied eligibility under the residual program for those children with developmental disabilities who were classified as eligible for Medi-Cal because they were at risk of being institutionalized (called "institutionally deemed") regardless of their family income status. Those advocates reported that some county workers said that the state funded IHSS Residual Program was only open to those Medi-Cal recipients who were income eligible, based on instructions sent to counties by the Department of Social Services last year and may not be aware of the new federal waiver.

Background of the IHSS Quality Assurance Program
* The Quality Assurance initiative was authorized in SB 1104, Chapter 229 Statutes of 2004) was signed into law on August 16, by Governor Schwarzenegger as one of the several budget related or "budget trailer" bills passed by the Legislature in late July  2004.
* As previously reported, the Schwarzenegger Administration believes that the "quality assurance" and "program integrity"  program provisions will reduce fraud, abuse and make services more efficient without harming the program or the people they serve.  Some advocates however are concerned that the IHSS "quality assurance" initiative could result in arbitrary cut in some service hours and other reductions - something the Administration disputes.
* The IHSS "quality assurance" program and the "program integrity" measures are part of a larger effort by the Schwarzenegger Administration to resolve  funding and resources for critically needed health and human services, including Medi-Cal, and regional center funded services for children and adults with developmental disabilities.
* Some  advocates are concerned that the measures underscore a trend by both the previous Davis Administration and the current Administration to address rising costs of services by people with disabilities and seniors (called "utilization") and increasing caseloads (the numbers of people eligible and using those services) by imposing changes that would have the impact of simply reducing caseload and utilization.  Some advocates raise concerns that inappropriate standardizing ofservices and supports for people with developmental and other disabilities doesn't address individualized needs that make a difference in a person's quality of life and a person's rights.
* Some advocates point to efforts in Medi-Cal, in regional center funded services for children and adults with developmental disabilities, including family share of cost, and previous attempts by the Davis and Schwarzenegger Administration to impose purchase of services statewide standards or limits to spending, as examples of that trend.  Administration officials however contend that making health and human services more efficient means that "core services" can be protected to those people who need it as opposed to reducing or eliminating needed benefits for everyone.

DETAILS OF THE MEETING
An agenda will be available about one week prior to the meeting date, but will cover an update on the implementation of the IHSS Quality Assurance Program and related efforts.  A conference call line will be provided to allow persons to participate remotely (that number will be made available about one week prior to the meeting).  This information will be reported immediately in a CDCAN Capitol News Report, and also posted on the CDCAN website at www.cdcan.us
When:
January 25, 2005 (Wednesday morning) 09:00 AM to 12:00 noon
Where:
Department of Social Services Building - Main Auditorium (first floor)
744 P Street, Sacramento, 95814-5512 (between 7th and 8th Streets)
Parking:
* Street metered parking - strictly enforced
* Closest public parking is lot between L and Capitol Mall, entering on 7th Street [$9 for all day - no in and out privileges]
Special Needs And Accommodations
* Conference Call (telephone) line to the 1/25/05 meeting OR
* Reasonable accommodations due to a person's disability to attend this meeting or if meeting materials need to be provided in alternative formats (including Braille, large print, computer disk or tape cassette), contact Linda Williams, Quality Assurance Coordinator (Department of Social Services) at 916/229-4000

NEXT STEPS
* The Department of Social Services said that the October 18th meeting - and the January 25th meeting are the first in a series of "stakeholder" meetings on IHSS Quality Assurance.  More meetings will be scheduled, in addition to meetings of various "work groups" that will be established to focus on specific components of IHSS Quality Assurance, over the next several months.  Some advocates have praised the Department of Social Services for its efforts on outreach for these meetings, though some organizations said they didn't receive notice of the first meeting.
* The 2005-2006 budget that Governor Schwarzenegger will propose January 10, 2005  (with a revised proposed issued in May 2005) could mean new proposals and budget savings that could impact the IHSS Quality Assurance program.
* The first Disability/Senior Rights Townhall Telemeeting for 2005 is scheduled for Friday morning, January 14 from 10 AM to 12 noon and will feature updates and impact of the proposed state budget for 2005-2006. See CDCAN website at www.cdcan.us to participate (click on "townhall telemeetings")

WHO IS IMPACTED AND WHO SHOULD COME
* IHSS recipients, their families, advocates for people with disabilities, including people with traumatic brain injuries, spinal cord injuries and seniors, IHSS workers, public authorities, public authority advisory committees, local county governments, regional centers, independent living centers, area boards on developmental disabilities and other advocacy groups.
* SB 1104  requires that the Department of Social Services to meet with representatives of groups representing those impacted and others (called "stakeholders")  who are directly impacted by the "quality assurance" initiative.
 

URGENT - CONTRIBUTIONS NEEDED TO CONTINUE EFFORT CAN CONTRIBUTE VIA NON-PROFIT 501(c)3  see below
Many many, thanks again,  to the friends, people with disabilities and their families, community organizations and others who have sent in generous and needed contributions and donations.  Contributions from people and organizations is very urgently needed to keep the advocacy efforts going for the next several months, as we work to establish non-profit status which we are working on.. Apologies to anyone who have not yet received a thank you - email, letters, calls have been overwhelming!  Your help is needed though to keep the effort going in 2005.
Please make check or money order  to:  California Disability Community Action Network  (or abbreviate CDCAN) OR, if for tax deduction purposes, you can make the check out to TTSR (Training Toward Self Reliance), which is a 501C-3 non-profit organization, and indicate on check that contribution is for support for "CDCAN".
A method to contribute by credit card (through Paypal) is NOW set up on our website, at www.cdcan.us [new site address]  Send contributions to: California Disability Community Action Network,  1225 8th Street Suite #480, Sacramento, CA  95814.
* Who Is CDCAN?
The California Disability Community Action Network is a non-partisan link to thousands of Californians with developmental and other disabilities, people with traumatic brain and other injures, seniors and their families, community organizations and providers, direct care and other workers, and other advocates.
These action alerts and news reports is for all of them. In addition it also goes to news organizations, state and local government officials and staff.
* How To Receive CDCAN Capitol News Reports and Alerts
If you would like to get on this distribution (and conversely, get off of it) please send an email with that  request to:  martyomoto@rcip.com OR sign up via the
NEW CDCAN website at www.cdcan.us  Sharing information is part of our organizing effort. Please feel free to forward or copy  this (attribution is nice). We're all in this together!
* How To Contact CDCAN
Marty Omoto, director/organizer  WEBSITE:  www.cdcan.us [new address]
1225 8th Street Suite 480 Sacramento, CA 95814   VOICE PHONE: 916/446-0013
FAX number: 916/446-0026        email: martyomoto@rcip.com