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TO: |
Public Authority Governing Body |
SUBJECT
ADJUST THE FISCAL YEAR 2024-25 ADMINISTRATIVE BUDGET FOR THE IN-HOME SUPPORTIVE SERVICES PUBLIC AUTHORITY AND ADOPT THE FINAL FISCAL YEAR 2025-26 ADMINISTRATIVE BUDGET FOR THE IN-HOME SUPPORTIVE SERVICES PUBLIC AUTHORITY (DISTRICTS: ALL)
Title
Body
OVERVIEW
The County of San Diego (County) In-Home Supportive Services (IHSS) program provides in-home assistance to approximately 47,000 Medi-Cal eligible low income, aged, blind, and disabled adults and children. This program enables them to remain safely in their homes, thereby reducing the need for more costly placements in nursing homes or other care facilities. In-home assistance is provided to IHSS recipients by IHSS caregivers, of whom approximately 76% are relatives. The IHSS Public Authority provides numerous services to nearly 43,000 IHSS caregivers, including training, payroll services, funding for benefits, and State-mandated caregiver enrollment, including criminal background checks. The IHSS Public Authority also provides registry services to IHSS recipients in need of caregivers.
On June 25, 2024 (IA01), the County In-Home Supportive Services (IHSS) Public Authority Governing Body adopted, by resolution, the recommended IHSS Public Authority administrative budget of $50,923,327 for Fiscal Year (FY) 2024-25. Today’s actions request to increase the FY 2024-25 IHSS Public Authority administrative budget by $600,000, for a total final administrative budget of $51,523,327, which will increase spending authority to allow continuity of operations through the current fiscal year.
On June 3, 2025 (16), the County of San Diego In-Home Supportive Services (IHSS) Public Authority Governing Body received the recommended IHSS Public Authority administrative budget of $57,470,255 for FY 2025-26 and set June 3, 2025, as the start date of public hearings for the budget. Today’s actions request adoption of the FY 2025-26 final administrative budget for the IHSS Public Authority by resolution, which is required by State statute. Adopting the FY 2025-26 administrative budget will allow the IHSS Public Authority to continue administering vital programs and services to caregivers and recipients who are part of under-resourced groups by identifying and removing barriers for engagement and participation.
This item supports the County vision of a just, sustainable, and resilient future for all, specifically those communities and populations in San Diego County that have been historically left behind, as well as our ongoing commitment to the regional Live Well San Diego vision of healthy, safe, and thriving communities.
RECOMMENDATION(S)
EXECUTIVE DIRECTOR/CHIEF ADMINISTRATIVE OFFICER
1. Transfer appropriations of $600,000 within the Health and Human Services Agency, from Services & Supplies to Operating Transfer Out, to fund the In-Home Supportive Services (IHSS) Public Authority (Org 63450) based on unanticipated IHSS Public Authority State General Fund revenue; and establish appropriations of $600,000 in the IHSS Public Authority, Services & Supplies, based on an Operating Transfer In from Health and Human Services Agency General Fund, to support the cost for Public Authority. (4 VOTES)
2. Adopt the Resolution entitled: ADOPT FINAL BUDGET FOR THE COUNTY OF SAN DIEGO IN-HOME SUPPORTIVE SERVICES PUBLIC AUTHORITY FOR THE FISCAL YEAR COMMENCING JULY 1, 2025.
EQUITY IMPACT STATEMENT
The County of San Diego (County) In-Home Supportive Services (IHSS) Public Authority utilizes available data from community feedback such as customer service satisfaction surveys, training surveys, community engagement events, and townhall meetings that lead to, and impact modifications to service delivery to more equitably serve the community. In Fiscal Year 2024-25, community feedback resulted in creating customized training for IHSS caregiver applicants requiring special accommodations, digitizing enrollment packets, participating in job fairs across San Diego County, facilitating a monthly virtual caregiver support group, and building new partnerships with community organizations to enhance resources for IHSS caregivers and recipients. In addition, the IHSS Public Authority continues to provide vital documents and assistance in all County threshold languages, American Sign Language, braille, as well as increasing accessibility to services.
The IHSS Public Authority regularly gathers input regarding accessibility, inclusivity, and improvement of the IHSS program and IHSS Public Authority services from members of the IHSS/Public Authority Advisory Committee. The IHSS/Public Authority Advisory Committee is comprised of individuals who are current or past users of in-home caregiver services paid for through public or private funds, or as recipients of IHSS. Current or past users of in-home caregiver services make up at least 51% of the committee membership, and community members make up the remaining 49%. The IHSS/Public Authority Advisory Committee conducts community outreach throughout San Diego County to increase awareness of the IHSS program.
SUSTAINABILITY IMPACT STATEMENT
Today’s proposed actions support County of San Diego (County) Sustainability Goal #1 to engage the community in meaningful ways by increasing outreach efforts throughout San Diego County, Goal #2 to provide just and equitable access to County resources and services by expanding service delivery to include virtual platforms, and Goal #4 to protect the health and well-being of everyone in the region by providing in-home care training modules to In-Home Supportive Services (IHSS) caregivers. These goals are further supported by 1) requesting and responding to recommendations and feedback from community stakeholders; 2) expanding training services, improving the electronic IHSS caregiver enrollment process and increasing IHSS caregiver recruitment efforts throughout San Diego County; and 3) administering IHSS caregiver support services that assist IHSS recipients with remaining in their own homes and avoiding institutionalization.
FISCAL IMPACT
If approved, the recommended actions will result in no additional costs in the Health and Human Services Agency, and an increase in appropriations of $600,000 in the In-Home Supportive Services (IHSS) Public Authority, for a total appropriation of $51,523,327 in Fiscal Year (FY) 2024-25. The recommended actions also provide spending authority of $57,470,255 for the IHSS Public Authority for FY 2025-26. There will be no change in net General Fund cost and no additional staff years.
BUSINESS IMPACT STATEMENT
N/A
Details
ADVISORY BOARD STATEMENT
The Fiscal Year 2025-26 recommended In-Home Supportive Services Public Authority administrative budget was presented to the In-Home Supportive Services/Public Authority Advisory Committee as an informational item on May 9, 2025, and to the Aging & Independence Services Advisory Council as an informational item on May 12, 2025.
BACKGROUND
The County of San Diego (County) In-Home Supportive Services (IHSS) provides homemaker and personal care assistance to approximately 47,000 Medi-Cal eligible low-income, aged, blind, and disabled adults and children, who need help to remain safe and independent in their own homes and avoid more costly institutional placement in nursing homes or other care facilities. The IHSS Public Authority was established, in accordance with State law, to act as the Employer of Record for IHSS caregivers and negotiate with United Domestic Workers of America (UDW). The IHSS Public Authority provides a wide range of services to over 43,000 IHSS caregivers, including training, payroll services, funding for benefits, and State-mandated caregiver enrollment, including criminal background checks. Furthermore, the IHSS Public Authority operates a registry of caregivers, which assists IHSS recipients in need of identifying an available caregiver. The IHSS Public Authority works in partnership with the County-operated IHSS program to serve both IHSS recipients and IHSS caregivers.
IHSS Public Authority anticipates exceeding Fiscal Year (FY) 2024-25 appropriations due to insurance increases in employee benefits and commercial insurance, one-time information technology costs, and an updated allocation of costs for rents and leases. All increased costs will be offset by additional program revenue.
In FY 2024-25, the IHSS Public Authority provided:
• State-mandated enrollment training to 10,296 IHSS caregivers;
• Training and education services to 3,317 IHSS caregivers on the State-mandated Electronic Timesheet System;
• Registry training to 2,178 caregivers;
• IHSS and Waiver Personal Care Services Back-Up Provider System services to 647 IHSS recipients in urgent need of a temporary IHSS caregiver; and
• Virtual recognition event for IHSS caregivers, in collaboration with UDW.
Below is an overview of the recommended FY 2025-26 IHSS Public Authority administrative budget:
|
Administrative Budget Component |
FY 2025-26 |
Comments (As Compared to FY 2024-25 Adopted Budget) |
|
Salaries and Benefits |
$6,829,401 |
$0.1 million decrease due to adjustments to align with spending trends |
|
Services and Supplies |
$3,887,361 |
$0.3 million increase due to insurance coverage costs |
|
Health, Dental, and Life Insurance Benefits for IHSS caregivers |
$46,753,493 |
$6.3 million increase due to increase in insurance benefit contributions for IHSS caregivers resulting from program growth |
|
Total |
$57,470,255 |
$6.5 million or 12.9% increase from the FY 2024-25 Adopted Budget |
The recommended IHSS Public Authority administrative budget of $57,470,255 for FY 2025-26 represents an increase of 12.9% from the FY 2024-25 Adopted Budget of $50,923,327. This increase is mainly due to increased health benefit contributions for eligible IHSS caregivers. In accordance with the revised Memorandum of Understanding (MOU) with UDW, authorized by the IHSS Public Authority Governing Body on February 7, 2023 (IA01), the IHSS Public Authority contribution for health and life insurance benefits is calculated based on the number of paid IHSS hours, at $0.63 per paid IHSS hour. The FY 2024-25 Adopted Budget for health and life insurance benefits is budgeted at 64,067,198 paid IHSS hours, and in FY 2025-26, providers are projected to deliver 74,069,037 hours of service based on continued program growth.
Furthermore, the approved MOU includes contributions from the IHSS Public Authority for non-health benefits, including a $50,000 annual payment for job-related personal protective equipment supplies, and an annual contribution to the UDW Trust of up to $40,000 for distribution to IHSS caregivers to cover the cost of transportation passes. Health benefits and other non-health benefits are funded by IHSS federal and State revenues.
Today’s actions request the approval to increase the FY 2024-25 IHSS Public Authority administrative budget by $600,000, for a final administrative budget of $51,523,327, and pursuant to California Government Code Section 29088, the approval of the IHSS Public Authority FY 2025-26 Recommended Administrative Budget by adopting the Resolution entitled: ADOPT FINAL BUDGET FOR THE COUNTY OF SAN DIEGO IN-HOME SUPPORTIVE SERVICES PUBLIC AUTHORITY FOR THE FISCAL YEAR COMMENCING JULY 1, 2025.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Today’s proposed actions support the County of San Diego 2025-2030 Strategic Plan Initiatives of Sustainability (Economy & Resiliency), Equity (Health & Economic Opportunity), Empower (Workforce & Innovation) and Community (Engagement, Safety, Quality of Life, Communications, & Partnership), and the regional Live Well San Diego vision by continuing to provide services to In-Home Supportive Services caregivers who assist low-income, vulnerable older adults, and disabled residents of San Diego County.
Respectfully submitted,
THOMAS H. JOHNSON EBONY N. SHELTON
Executive Director Chief Administrative Officer
ATTACHMENT(S)
Attachment A - ADOPT FINAL BUDGET FOR THE COUNTY OF SAN DIEGO IN-HOME SUPPORTIVE SERVICES PUBLIC AUTHORITY FOR THE FISCAL YEAR COMMENCING JULY 1, 2025