4-46 Program Locator County Health Aging and Adult Services Conservatorship Program Community-Based Programs IHSS Public Authority IHSS Public Authority GF Headline Measures 100% 80% 60% 40% 20% 0% 100% 80% 60% 40% 20% 0% Percent of Consumers Without Caregiver Resources Who Find an IHSS Provider Through the Public Authority Registry 99% 100% 100% 04-05 05-06 06-07 98% 98% 07-08 Percent of Caregiver Survey Respondents Rating Services Good or Better 08-09 96% 98% 97% 90% 90% 04-05 05-06 06-07 07-08 08-09 Program Outcome Statement The Public Authority for In-Home Supportive Services (IHSS) promotes the dignity, independence, health, and safety of at-risk lowincome seniors, disabled adults, and children and their families in San Mateo County. This program helps these individuals remain safely in their community by enhancing the quality and availability of in-home care services and by empowering them to live a healthy and safe lifestyle in their own homes. Services and Accomplishments The Public Authority (PA) contributes to the goals of the Shared Vision 2010 commitment to Ensure Basic Health and Safety for All by providing assistance to IHSS consumers in finding a caregiver. The PA recruits individuals to be in-home caregivers, maintains a registry to assist consumers in finding IHSS workers, administers the payroll of IHSS workers, and provides support and training for both consumers and in-home caregivers. A bilingual/bicultural staff enhances the PA s ability to provide services to a diverse population of providers and clients. Consumers of Aging and Adult Services (AAS) are encouraged to participate on the PA Advisory Committee and other commissions/committees of AAS. The PA has a unique relationship with the County. While technically a freestanding organization, it is programmatically integrated into the day-to-day operation of AAS. Its colocation with AAS further enhances the coordination of a wide variety of services and support provided. Because of this special relationship, the PA is able to access the support of the County s infrastructure; e.g., County Counsel and Human Resources. Proximity to AAS program staff also enables the PA to provide joint home visits with AAS Social Workers. San Mateo County s PA has served as a model for other counties in the development of Public Authorities that are integrated into county service systems for seniors and persons with disabilities. The following are major accomplishments in the current year: Conducted home visits with consumers and providers to clarify responsibilities and expectations, and mediate conflicts between the parties Increased the number and locations of training opportunities for providers, including the development and distribution of a sixmonth calendar of trainings to providers in order to encourage greater attendance Worked with the Regional Occupational Program to provide a conduit for students to enter the workforce Created a brochure to promote the Public Authority s services and to recruit more homecare workers Revised the timesheet training program to reduce the number of replacement timesheets requested each month Used the new automated, integrated client data and case management system (the Q system) to further integrate the Public Authority into AAS
4-47 Story Behind Performance A primary goal of the PA is to assist IHSS consumers by supporting their independence and meeting their homecare needs. Headline Measure 1 depicts one key indicator of successful performance in meeting this goal. Over the past three years, at least 98% of consumers without caregiver resources were able to find an IHSS Provider through the PA Registry. This is a reflection of the PA s ability to maintain a current registry of potential and available providers and to recruit caregivers from as many geographic locations throughout the county as possible. The PA conducts consumer satisfaction surveys to monitor the success of its programs. As seen in Headline Measure 2, at least 96% of caregivers rate the services provided by the PA as good or better. Surveys also indicate that PA services improve the quality of living situations for at least 93% of the consumers served, and 99% of individuals state that they have gained useful knowledge from trainings attended. Enhance the Protection of Consumers and Caregivers Continue to conduct background investigations of Registry caregivers Provide training for caregivers on disaster/emergency preparedness Include health and safety information in newsletters and continue to coordinate with Public Health on mailings to providers Provide information on identification and reporting of suspected elder and dependent adult abuse and child abuse Work with IHSS Quality Assurance staff to identify potential service delivery issues for consumers Major challenges over the next two years will be: To provide homecare services to consumers who are difficult to serve due to issues such as geographic location, limited public transportation, high cost of living, and/or lack of providers with specialized training To develop and expand programs beyond the categorical funding requirements that limit Public Authority services to IHSS consumers To continue to develop strategies to retain and recruit quality home-care providers To develop and provide literature that is culturally sensitive and available in multiple languages to meet the needs of the changing community Program Objectives The IHSS Public Authority will meet performance targets by doing the following: Ensure At Least 98% of Potential Consumers Without Caregiver Resources Find A Caregiver Through the PA Registry Maintain an accurate Registry of potential caregivers Recruit caregivers from all geographic regions, reflecting the County s diversity Achieve an Overall Caregiver Satisfaction Rate of at least 90% Enhance the network of support for providers Offer additional information and training to consumers and IHSS providers on effective communication, hiring processes, setting limits, and monitoring hours Continue to improve the education, knowledge, and skills of caregivers and increase consumer awareness and understanding of caregiver responsibilities Provide a minimum of eight caregiving skills training sessions per year
4-48 Performance Measures Summary Table Performance Measures FY 2004-05 FY 2005-06 FY FY FY 2008-09 What/How Much We Do Average number of caregivers served by the Public Authority per month Number of consumers served by the Public Authority registry Number of caregivers and consumers attending Public Authority trainings per year Average number of timecards processed per month 2,043 2,157 2,315 2,300 2,300 243 217 264 230 230 --- --- 244 225 225 --- --- 5,434 5,395 5,395 How Well We Do It (Quality) Percent of consumers without caregiver resources who find an IHSS provider through the Public Authority registry Percent of caregiver survey respondents rating services good or better Average number of days to obtain a match between a caregiver and consumer through PA registry 99% 100% 100% 98% 98% 96% 98% 97% 90% 90% 7 5 5 7 7 Is Anyone Better Off? (Outcome) Percent of consumers indicating the quality of their living situation has improved as a result of services received through the Public Authority Percent of individuals receiving training who indicated useful knowledge gained 93% 95% 93% 96% 96% 99% 99% 100% 95% 95% Resource Allocation Summary 2005-06 Revised Change 2008-09 Total Requirements 13,254,449 14,586,353 15,556,782 16,746,924 1,190,142 16,894,336 Total Sources 13,254,448 14,586,353 15,556,782 16,746,924 1,190,142 16,894,336 Program Net County Cost The portion of this program s FY Budget which is funded by the General Fund or Net County Cost (NCC) is $4,487,523 or 29% of the total cost of the program. No portion of this amount is discretionary.
4-49 FY Program Funding Adjustments The following are significant changes from the FY Revised to the FY Budget: 1. Adjustments to Provide Current Level of Services Budget adjustments have been made to meet performance targets: inclusion of merit increases; annualization of mid-year position changes; and a decrease in the County share of Individual Provider pay due to the IHSS waiver. 63,697 (175,185) 0 238,882 0 0 2. Increase in Salary and Benefits to Independent Providers (IP) Additional appropriations reflect higher salary costs paid to In-Home Supportive Services (IHSS) IPs due to an increased State wage cap and negotiated ìncreases in the number of health, dental, and vision insurance slots for IPs. The additional costs are fully offset by increased federal IHSS funding and Realignment revenue. 1,126,445 1,126,445 0 0 0 0 TOTAL FY PROGRAM FUNDING ADJUSTMENTS 1,190,142 951,260 0 238,882 0 0 FY 2008 09 Program Funding Adjustments The following are significant changes from the FY to the FY 2008-09 Budget: 3. Adjustments to Provide Current Level of Services Budget adjustments have been made to meet performance targets: inclusion of merit increases; and an increase in Realignment revenue. 15,274 15,274 0 0 0 0 4. Adjustments to Fund Balance Increased Fund Balance from the prior year is being set aside in IHSS Public Authority Fund Reserves for future payment of IP benefits. 132,138 132,138 0 132,138 0 0 TOTAL FY 2008-09 PROGRAM FUNDING ADJUSTMENTS 147,412 147,412 0 132,138 0 0
4-50 IHSS Public Authority Fund FY and 2008-09 Budget Unit Summary 2005-06 Revised Change 2008-09 SOURCES Use of Money and Property 65,993 46,553 Intergovernmental Revenues 5,505,493 6,791,090 7,943,315 8,894,575 951,260 8,909,849 Interfund Revenue 4,619,568 4,622,328 4,487,523 4,487,523 4,487,523 Miscellaneous Revenue 3,179 438 Total Revenue 10,194,233 11,460,409 12,430,838 13,382,098 951,260 13,397,372 Fund Balance 3,060,215 3,125,944 3,125,944 3,364,826 238,882 3,496,964 TOTAL SOURCES 13,254,448 14,586,353 15,556,782 16,746,924 1,190,142 16,894,336 REQUIREMENTS Salaries and Benefits 271,168 366,227 480,274 573,938 93,664 589,212 Services and Supplies 2,296,946 2,565,877 2,386,726 2,977,379 590,653 2,977,379 Other Charges 7,560,391 8,289,423 9,431,700 9,698,643 266,943 9,698,643 Net Appropriations 10,128,505 11,221,527 12,298,700 13,249,960 951,260 13,265,234 Non-General Fund Reserves 3,125,944 3,364,826 3,258,082 3,496,964 238,882 3,629,102 TOTAL REQUIREMENTS 13,254,449 14,586,353 15,556,782 16,746,924 1,190,142 16,894,336