Health System: IHSS Public Authority (5800P)

Program Outcome Statement

Keep people at home with caregiver support.


The Public Authority (PA) supports low-income seniors and people with disabilities to remain safely at home by providing In-Home Supportive Services (IHSS) caregivers. IHSS caregivers assist with tasks of daily living such as toileting, bathing, dressing, and feeding. The caregivers may also provide services such as cooking, laundry, and accompaniment to medical appointments. The PA manages 5,000 caregivers for over 4,300 beneficiaries by recruiting caregivers, maintaining a registry, conducting background checks, conducting caregiver orientations and training, and managing caregiver wages and health benefits. Since 2005, there has been an 60% increase in number of caregivers in the County. Without these caregiver services, these seniors and people with disabilities may require institutional care, which would diminish the quality of life for the clients and have a significant negative impact on the entire Health System. In addition, the orientation and training provided for the caregivers increase the quality of care to clients, allowing clients to remain in the community for a longer period of time.

IHSS Costs for County Component Below Target

Number of Days it Takes to Get IHSS Services Meeting Target

Average Number of Days it Takes to Provide a Registry Caregiver Meeting Target

FY 2017-18 Mid-Year Story Behind Performance

Number of Days to Get IHSS Services

The number of days for a client to receive IHSS services is derived from a combination of IHSS and Public Authority procedures, the time it takes for a client to identify a provider and the time is takes for a provider to comply with completing enrollment requirements.

IHSS Costs

The fiscal year 2017-18 target reflects an estimated 7 percent increase in IHSS hours year over year. The year-end estimate, which is based on the first 6 months of the fiscal year, shows a growth of approximately 4 percent. The County cost target was set based on the IHSS MOE established. We will not be meeting the County cost target because the State has reduced the allocation to cover IHSS and Public Authority administration by 11 percent and 26 percent respectively, which in turn shifts additional costs to the County.

Average Number of Days it Takes to Provide a Registry Caregiver

The increased workload for IHSS staff have led to an increased number of days it takes an IHSS recipient to hire a registry provider. 

Future Priorities

  • Provide workshops to improve job readiness of IHSS providers.
  • Increase the number of IHSS home care providers in the Public Authority registry by continuing targeted recruitment of IHSS providers to join the registry and to increase language capacity to meet the needs of IHSS clients.

Author: Gina Wilson, Chief Financial Officer, Health System     Contact Email:    Last Updated: 01-30-2019