Board Opposes Governor’s Plan to Increase County’s Share of Medicaid Costs

RIVERSIDE – The Board of Supervisors have authorized a letter to legislative leaders appealing for opposition to the governor’s proposal to shift a greater share of in-home supportive services costs to counties in the next fiscal year, potentially forcing Riverside County to slash funding for other programs to cover IHSS.

The board without comment during it’s March 21 meeting approved sending the opposition letter to Assemblyman Phil Ting, D-San Francisco and Sen. Holly Mitchell, D-Los Angeles, both of whom are key players in the budgeting process underway in Sacramento.

“The governor’s budget proposal shifts an unfunded mandate to counties that will have devastating implications for all local services,” according to the letter.

Gov. Jerry Brown’s 2017-18 budget blueprint included a proposal to drop the coordinated care initiative and maintenance of effort stipulation in effect for the last few years, which have capped counties’ IHSS costs at a 3.5 percent annual growth rate and limited their general obligations to one-third of total expenditures needed to fund the program. IHSS is operated under Medicaid, or in California, Medi-Cal.

IHSS provides direct assistance to low-income seniors and the disabled who are living independently, including meal preparation, bathing, medication dispensation and other on-site care.

The governor stated in his January budget proposal that IHSS costs, due to growing recipient demand and higher labor expenses, had ballooned beyond appropriations limits established four years ago, adding to the state deficit.
The California Department of Finance recommended realigning IHSS costs, making counties responsible for a higher share. Brown agreed.

Changing cost-sharing responsibilities would make counties responsible for more than $600 million in IHSS expenses in 2017-18, according to the governor’s budget.

The board’s letter noted that the county could be faced with an additional $43 million in mandated expenses under the governor’s plan, and that figure would only climb, reaching $165 million by 2023.

According to the letter, there are 30,541 active IHSS recipients in the county now, but another “23,000 aged, blind and disabled Medi-Cal clients are potentially eligible.”

Caseload growth is averaging 13 percent per year, county officials said.

The letter stressed that the only way the county could afford to fund IHSS under the governor’s realignment plan and not bust its budget would be to strip funding from other programs, including health care.

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