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 maintaining a registry of potential caregivers that in-home support services (IHSS) recipients may choose to hire. 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 5,500 caregivers for over 5,000 beneficiaries by recruiting caregivers, maintaining a registry, conducting background checks, conducting caregiver orientations and training, and managing caregiver wages and health benefits. From 2008-2018, there has been a 48% 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 Exceeding Target

Average Number of Days it Takes for an IHSS Recipient to Hire a Registry Caregiver Meeting Target

FY 2018-19 Mid-Year Story Behind Performance

Number of Days to Get IHSS Services

We are currently reviewing how the data is collected for this measure based on recent program changes and will have data at year-end.

IHSS Costs

Targets estimates a 7% increase in IHSS hours. Actual increase is closer to 5%, which is leading to lower program costs than estimated.

Average Number of Days it Takes for an IHSS Recipient to Hire a Registry Caregiver

Since FY 2016-17 there has been a 40 percent increase in the number of IHSS recipients without caregiver resources who are being served by the Registry. In addition, with the termination of our IHSS contract-mode of service, difficult to serve IHSS recipients are now being referred to the Registry. The combination of an increased workload and more challenging population to serve has increased the number of days it takes for an IHSS recipient to hire a Registry provider, yet we were able to meet the target of 10 days for the first 6 months of FY 2018-19.

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: 01-22-2019