Senate Budget and Fiscal Review Subcommittee No. 3 on Health and Human Services

Budget Subcommittee number three will commence. All right. Hello, everyone. Good morning. For those who were tuned in with my driving saga from last week, it was the longest drive I've had to do ever, even though we got out here on a good time.

So this time I don't have to drive. So we can be here till 10:00 p.m. So I'm very excited about that. Last flight out to LAX is 11:25. So we're okay.

So with that, we have three different departments that are going to be presenting to this Subcommittee. We're going to be hearing from the California Department of Social Services, Department of Community Services and Development, and California's Department on Aging.

We will be doing the same thing we did last week, where we'll get public comment after each Department. I think it went very smoothly last week, and we'll continue in that order. So we will ask DOF and LAO to get comfy up in the well, please.

And then I will ask the Administration to start us off with Department of Social Services. Our first issue up is going to be on the Child Care Rate Reform. We're going to first hear from LAO and we'll dive into the rest of our panelists today. We're going to be hearing from the Department.

We have someone from the Early Care and Education Coalition. We're going to have someone from the CCPU, and then Department of Finance will close us off. Welcome back. Thank you. May begin.

Jackie Barocio with the Legislative Analyst Office. We were asked to walk through the alternative rate methodology, timelines and milestones that were codified as a part of the 23-24 Budget act through SB 140.

But before I go over the timeline, I do first want to provide kind of a quick, high level overview of prior work that was done to develop a single rate reimbursement structure that the timeline then builds upon.

Specifically, in 2021, the Legislature ratified the agreement that was reached between the state and the Child Care Providers United Union that included the creation of the Joint Labor Management Committee. And that Committee was specifically tasked with developing a single reimbursement rate structure.

And then in November 2022, the Joint Labor Management Committee, or JLMC, released its recommendations on how to structure an alternative single reimbursement rat. Which included developing rates based off of a model that estimates the true cost of providing childcare services, including base rates that are tailored to each program setting and current rules and regulations.

And then also allowing for rate enhancements and incentives. In addition, the JLMC recommended that the single rate structure be evaluated based off of certain equity and process metrics.

So with these JLMC recommendations, they really serve then as the starting point for the alternative methodology, timeline and milestones that were adopted last year through SB 140.

In terms of where we are today, the current milestone that the Department of Social Services, or DSS, is working on is collaborating with the JLMC to define elements of base rates and any enhancements for the purposes of informing a potential single rate structure. And these elements would be subject to the mandated public engagement, state plan process and legislative review.

And then, once that work is completed, the Department will provide an update to the Legislature on progress made thus far. The Department was supposed to complete reaching those definitions in collaboration with the JLMC by February 15.

However, our understanding is that DSS is still actively working on completing that. In terms of the next milestones that would follow those landing on the definitions, our understanding is that the JLMC, since it was created out of the union, it primarily is focused on family based providers.

So then we would also have to capture the center based provider perspective and the Department would seek feedback that's specific to the center based provider structure, cost model and rate elements this March 2024. The next milestone that's outlined in statute is by May 15, 2024. The Department is required to report to the Legislature on the status of the draft Childcare and Development Funding state plan.

Then, by July 1, 2024 the Department is required to submit a revised state plan to the Federal Government that includes the necessary information to support the use of a new single rate structure for all childcare providers. And then within 60 days of the federal approval of that state plan that's submitted, the Department then shall provide both the union and the Legislature with an outline of implementation components, and then the union and Legislature would have 30 days to provide feedback.

Within 90 days of federal approval, the current MOU agreement that's in place will be reopened for both the union and the Administration to negotiate. Then how do we restructure rates based off of this alternative methodology for family based providers again?

And then a parallel process would occur for center based providers concurrent with and informed by that MOU process, and that would occur through the normal annual budget process.

One thing that I definitely want to clarify is with regards to that July 1, 2024 submission date, that does not necessarily mean rates will be implemented by July 1, 2024. It really is just the deadline to submit the state plan to the Federal Government.

The Federal Government actually gives states up to July 1, 2025 to implement rates based off of this alternative methodology and SB 140 doesn't specify an implementation date. So we believe that the state likely would need those 12 months to land on key implementation details like what is the phased in approach, associated funding, things like that.

That would occur normally through the MOU process and the annual budget process. So with that, I'm happy to pass it over to other panelists.

Thank you so much, Jackie. Hi. Welcome back, Director.

Thank you so much. Good morning, Madam Chair. Senator Roth. Kim Johnson, Director of the California Department of Social Services and just grateful to be able to have this opportunity to give you an update on this work and really building on the investments that the Governor and Legislature have made, historic investments over the past few years. We're glad to be moving from envisioning a single rate structure to actually taking the steps needed to implement this new system.

The Committee has asked us for an update on the following items. One, the federal guidance and requirements for moving to this alternative methodology to set rates a description of the cost model and how it functions, including the elements of the base rate and enhanced rates, and the progress that we've made today, including the submission of the update to the Legislature. So I'll start with the federal guidance.

The Administration for Children and Families require states to collect data from the childcare and development providers and programs to inform the childcare subsidy rate setting within two years of submitting that state plan that was just referenced by the LAO.

California, like most states, have historically used a market rate approach to meet this requirement and as your agenda outlines, the Administration and Legislature have agreed to utilize an alternative methodology to inform subsidy rate setting.

ACF is required to preapprove any state proposal to pursue this alternative methodology, and in March of last year, the Department of Social Services submitted this proposal to ACF and that proposal was formally approved by the Federal Government in August of last year.

ACF issued a letter in August also that clarified expectations for this July 1 of this year's submittal of the state plan for states that are moving to the cost based method.

The guidance recognized that states transitioning to this alternative methodology might not have enough time to complete all associated activities by July 1 of 2024 and granted those states flexibility on timelines subject to certain conditions.

Those conditions include that the plan that we do submit in July of this year has to have a status update on the alternative methodology, a timeline by which the alternative methodology activities will be conducted, any completed steps to date, anticipated date of completion and expected date new rates will be in effect.

It also requires states to continue to prioritize payment rate increases as part of the state's strategy to ensure equal access to childcare for all eligible children and families and increase payment rates adjusted for inflation.

It also requires completion of all required data collection analysis and submitting the detailed report and setting payment rates based on the methodology as the LAO referenced no later than July 1 of 2025.

I would just also note that lead agencies, the states with an approved alternative methodology by March 1, so that includes us, agreed to these terms and are not required to also conduct a market rate survey.

In other words, we're able to continue with this alternative cost model that we're working towards and not have to do the prior processes that we've done in the past, and we are on track for the July 1 submission to include all of those elements as outlined.

So, the cost model, what have we been doing and what does it look like? Just again, the cost estimation model generates a benchmark regarding costs. It's a tool to understand the cost of providing services, which estimates the cost of providing services aligned with what the programs are charging, identifies the gap between their costs and revenue sources, and it uses multiple data sources and points which are driven by the selections that we have in the tool.

It's a tool that we are using the cost model and elements of the structure are not the same as actual rate setting. We will use the model to inform our rate setting process. So between July and November of last year, the Department collaborated with our primary consultant, prenatal, to five fiscal strategies on public engagement, data collection, and developing the model.

During the public engagement phase, we consulted and engaged with many, many different interested parties and representatives throughout the field and during the data collection phase of the work we have conducted an online survey that sought to understand current program costs and how they differ by county by provider type, characteristics of children and families served, child age served, and community need. The survey was administered in seven language and had a total of 9250 respondents.

Over 100 virtual input sessions were also conducted in multiple languages to gather additional, richer qualitative data. Those sessions were attended by over 460 participants.

We also had multiple ad hoc groups, focus groups organized to better understand the costs, the cost drivers and the barriers to quality and how they differ for different programs and providers, and especially for children who are unhoused in families of unhoused, or in children who are dual language learners.

To facilitate access for providers who were unable or preferred not to complete the survey, we also worked with our consultant to do some one on one interviews. So the result is that California now has a customized analytical and modeling tool informed by the actual cost data from those surveys and interested party feedback.

The tool allows users to understand how the cost of care changes depending on the variables such as licensing requirements, program type, characteristics, ages of children served, number of children served, geographic location across the state, and others.

The tool also factors in subsidy levels and other forms of revenue at a very high level. The base elements that are within this cost model tool include things like ratios, child and teacher ratios, group size, staffing patterns for both the teaching staff as well as the nonteaching staff compensation.

So salary and benefits, professional development and training supports, family engagement, child education and development, child health and development supports. It also has enhanced rates that we're considering things like providing services at nontraditional hours for families and additional considerations.

So we are currently meeting, as was referenced with the Joint Labor Management Committee of Childcare providers united to finalize the elements. We met 12 times between December and February and four more times between February and yesterday.

And so glad to say that yesterday the Joint Labor Management Committee reached General consensus on definitions of the base and enhanced rate elements to inform again the state proposed single rate structure. We're working on then finalizing those documents and we'll be posting those and make available also to our rate and quality work, which is also again focused on the center based programs.

We will follow up to describe in specificity what I just high level outlined of those base elements and enhance rates based on for license exempt family, friend and neighbor providers, as well as licensed family childcare homes and of course, working with the rate and quality group on the center based components.

And then that will all be outlined in a report to the Legislature as we've completed that work yesterday, very soon and shortly. So you'll have that report with the detail included.

Again, I just would underscore we are on track to submit and meet the federal requirements to submit the state plan by July 1 of 2024. And again, just are really thrilled with the opportunity to be where we are in this process of implementation and operationalizing.

Yes, we will need to outline, as the LAO described, what those operational considerations look like to actually create our implementation date, and those are our next steps ahead.

But I just really want to appreciate all of the parties who have helped inform this process to date, and especially the members of the childcare providers united who sat in, in those meetings that I just referenced, really spending the time to make sure we get it right coming out of the gate. I'm glad to answer any questions, Chair.

Thank you, Director. I think from that it removes like 10,000 questions that I had. So it's really great news. We're going to move on. We're going to hold questions until the end. We're moving now on to Lawanda Wesley, who represents Early Care and Education Coalition. And then, Kimberly, you'll be after.

All right. Good morning. Thank you, Chairman Menjivar and fellow Committee Members, for your continued effort to support Childcare Rate Reform for deserving California childcare providers. I am Dr. Lawanda Wesley, the director of government relations at Childcare Resource Center.

We proudly serve 50,000 children and families in both of Los Angeles and San Bernardino County. It is my privilege to come before all of you as a former preschool teacher and educator and to represent thousands of children, families, and providers who do care about California's children.

I'd like to tell you three reasons why we must move and act urgently to address the impending childcare shortage crisis and immediately implement Child Care Rate Reform as promised by Governor Newsom and the Legislature.

The first reason is that we want to make sure that we increase and sustain a high quality childcare workforce, and we want to address the overdue racial and gender pay equities in the field and then acknowledge that California is heading towards a broken promise. Should I pause?

No, go ahead. Okay.

I'll keep going. All right. So the first reason around sustaining childcare, there has been, as we already know, multitudes of decades of research done here in California and also nationally. And what we want to do is continue to uplift those reports.

And they range from lifting children and families out of poverty task force that was conducted by the California Department of Social Services in 2018, the Blue Ribbon Commission in 2019, the Master Plan for Early Care and Education in 2020, and then, of course, our rate and quality work group that was just mentioned that has done work through 2022 is now reconvening to pick that back up.

With all of the combined research and the work groups, it's overwhelming consensus that we want to make sure that we sustain the workforce. And that means we need to adopt the rate reform right now and pay this field of women, primarily women of color, the livable wage they deserve for being highly skilled, competent.

And we know that this was done during the pandemic at a time where they were deemed as essential workers. And so that still is the situation to this day.

And the way I say it more plainly is in order to access and sustain a high quality, competent and skilled workforce, we must pay for the true cost of care. As of this writing, reported by the US Bureau of Labor Statistics, California has lost about 1300 jobs.

The rest of the country has started to rebound, but California still lags behind. And for my agency, in particular, childcare resource center, we have right now 24,000 children that are on the waiting list. So the need is there.

But we have childcare providers who are walking with their feet saying we need to take other jobs to make ends meet. And so what we're asking is there's pay equity right now, which is my second point, that we move forward with what was presented today, have at minimum a three year plan, but not wait another decade. We can't wait because we won't have a workforce sector to go to.

Right now, according to the state data, 73% of California's childcare providers are women and women of color, but they do not pay themselves a salary because the state does not compensate them accordingly. And so what we believe right now is that the system, I would like to say that it's broken, but I also feel at times it's designed that way.

Just recently I shared with the LA Times, and it was reported in the LA Times, that I myself, with advanced degrees, was at a pay of $19 an hour for a period of time, regardless of my education.

And so I have first hand witnessed what this was like as a preschool educator working in the field, relying on subsidies like Cal Works, medical and public housing. And again, I had an advanced degree.

According to the 22 US Bureau of Labor Statistics, childcare providers nationally earn about $13.71 an hour. And that's about 28,000 per year, which is not enough to cover basic needs or food. And as a result, as I said already, childcare providers are moving with their feet.

And I would like just to start to conclude and just share that recently the Center for the Study for Childcare Employment reported that many of our folks as of December 2023 are impacted by chronic health challenges that include anything from being impacted by obesity, cardiovascular issues and just chronic pain.

And so that with not having economic well being creates a problem. We also want to make sure that the 146,000 slots that were to be recouped this year is actually kept into this year's budget and not swept.

And so in close, we just want to make sure that we ask that the state develop again the new single rate alternative methodology system. And that is done in a transparent process, which is great to hear that we do have the quality rate work group to help with that process.

And of course, the work that's being done with CCPU through the JLMC. And then I just want to just close and say, we respectfully ask the Governor and the Legislature to keep its promise. And I am complete.

Thank you. Are we having one person speak from?

So I was also asked to speak from on behalf of the ECE.

So I think there was a misunderstanding. So I'm only going to be able to give you 2 minutes because we only allowed space for one speaker under ECE. Okay. So you may proceed. Ms. Andrea Fernandez Mendoza with 2 minutes.

Okay, thank you, Chair Menjivar and the Members of the Committee for this Opportunity. As you know, my name is Andrea Fernandez Mendoza. I'm Vice President of education at California Children's Academy.

I'm also a board member for every Child California, which is a proud member of the ECE coalition I'm representing here today, Members from Los Angeles County. Personally, we have 15 schools that serve over 134 infants, 163 toddlers, and 478 preschool children per day.

I've worked in the field for over 31 years and worked my way up the ladder from a volunteer summer youth worker to where I am today as Vice President. ECE has been an integral part of my life, both personally and professionally.

As a large center based provider of ECE high quality, I was thrilled that all of you had committed to strengthening the childcare workforce by finally addressing the antiquated rate system. Current reimbursement rates barely cover the cost of services.

Without the COVID subsidies and allowances that we've had, many centers like mine would have had to have closed. And many did. This is due to multiple factors, which include increase in food and utility costs, rent increases, increased insurance premiums, staffing costs, minimum wage increases, the cost of maintenance and facilities.

The cost of everything has risen for all of us, and especially in high cost cities and counties. There are many provisions that title five centers must follow which are not covered by reimbursement rates.

And to minimize our costs, we have to make the best of difficult situations. We find ourselves competing with fast food restaurants that offer high pay with less responsibility, and as a result, we're bleeding out our staff.

We are losing staff to fast food jobs, and we desperately need that continuity of care to provide a high quality education for the most vulnerable children of California in a safe and nurturing environment.

The promise of a single rate structure based on the cost of care methodology was a relief so far to our programs with the changes that were made for fiscal year with the hold harmless and has already showed positive impacts.

Changing from the attendance based enrollment to the enrollment based reimbursement, provided a stable and consistent stream of income, which allowed us to make our budgets around stable income streams and provided us for better financial planning. It also allowed us to stop.

Need you to wrap up soon.

Okay. I'm sorry. Again, thank you. If you have any questions about the methodology or how it's impact centers in Los Angeles County and all over the State of California, please feel free to ask. We're happy to answer any questions.

Thank you so much. Moving on to representative from CCPU, Kimberly Rosenberger.

Thank you so much, Madam Chair and Members. I had prepared notes, but as you heard from Director Johnson, we've made progress, so bear with me. We are incredibly appreciative of the legislative efforts to help keep us on track and accomplish the shared goals of providing a new methodology that's more inclusive of the whole picture of childcare in California.

We want to acknowledge this Committee and the Women's Caucus for prioritizing those workers and helping us move that conversation forward.

The JLMC worked to find a more meaningful way to reimburse providers appropriately for the cost of care. In doing so, we were tasked with fairly compensating all workers, which includes family, friends and neighbors.

All of that historically has been uncompensated time. This new proposed methodology provides meaningful compensation to give them the support they need.

That has been our biggest barrier, trying to overcome that, take into consideration their needs while fairly compensating everyone. And so that was a path we needed to address before we can move forward.

We have, I think, come to an agreement and I still need to emphasize the importance of family, friends and neighbors and why that was what took so long for us to finalize. They are one of the largest growing types of childcare.

They have helped increase access as the state expands slots. They provide alternative hours care in communities with the greatest need and have a high level of cultural competency. Despite this, they have long been overlooked.

While they may not have the same regulations as their peers in home and centers that have regulatory requirements in their day to day care, they are still meeting those requirements. They put forward efforts on a day to day basis for transportation, food prep, lesson plans, and providing a safe and clean space.

The support of the Legislature and efforts included, we also think has allowed for this breakthrough through to address them, but also to help encourage them to move forward in upward mobility. We are seeing more of them become licensed providers.

We think that they are helped grow the workforce that we so desperately need. We are optimistic that we will be finalizing our proposal and we look forward to the next steps in expanding that methodology to all workers, including centers.

We're appreciative of the support we have received in raising up the field as a whole. But we have to underscore time is of the essence. We are not done. We are just over one of our bigger barriers.

And so we look forward to continuing to work with you all as we look to achieve the goal of that new methodology and funding it moving forward. Thank you, and happy to answer any questions.

Thank you so much. Department of Finance. Do you have any comments to add to this?

Good morning, Chair. Krishan Malhotra, Department of Finance. We have nothing further to add at this time.

Great. Turning it back over to us for any questions. Director Johnson, first, I'm so grateful that you described some of what went into between August and November, 100 virtual input sessions, multiple ad hoc focus groups, survey and so forth, and you described even further what went into this. I'm very appreciative of the coalition, the workforce that really hammered in on this issue to get to where we are now.

And it sounds like we're going to meet that July 24 deadline, so we don't need to take advantage of the flexibility to push that back if that's needed.

That's correct. We plan to submit and meet that deadline.

Phenomenal. My question, well, actually, connecting to that, you shared some of the overarching themes, ratios, group size, staffing patterns that you're looking to include in the model. And more detail is to come in upcoming days on the report coming up. Okay, so that's correct where we're at right now, where you can share so far?

That's correct.

Perfect. Okay. I don't have any further questions for you. I would like to hear from providers, maybe you, Ms. Mendoza, I know how to cut you off a little bit. I don't know how much has been shared with outside groups or what is going to be part of this model to make up the reimbursement rates, maybe. Have they been part of it?

There are stakeholder meetings. They had to be paused, in large part because we didn't have a work product to share because we were still trying to figure out the runs. And I don't want to cut off Director Johnson.

I know there's intent, but we have, on our end, tried to keep our ECE partners in the loop. In large part. We've been accomplishing a lot of the conversation in the last couple of weeks. That's where the breakthrough has been. So there hasn't been as much information circulated up until now because we haven't had anything to share.

Okay.

We have a meeting next week, chair, and again, as I referenced, we are planning to post what we were able to come to agreement on with a definition so that will be part of the conversation.

Okay, I'm halting all my questions until we get to see this model that we're going to be utilizing for the reimbursement rates. Colleagues, any questions on this? This panel I thought was going to take longer, but I think you were just waiting. I'd like to give the opportunity now for any final thoughts since we do have some extra time here.

Chair Menjivar, if you don't mind, if I can answer question two that was posed to me just to give a little more insight onto considerations that the centers might need. So, as California moves to an alternative methodology, there are several items to highlight that should be considered.

Many center based providers, including myself, my peers, and staff, have engaged in the rate reform and quality work group to provide input and recommendations for the new rates specifically for center based providers. The subsidized field is very technical, and there are important requirements that are only applicable to direct contract childcare centers.

We have teacher qualification requirements, assessment requirements, environment necessary professional development, family support needed, family involvement, curriculum support, social emotional, classroom support needed to address challenging behaviors, multilingual learners, universal design for learning, and exceptional need supports, as well as many other aspects to providing quality early education for our littlest learners.

Important costs that should also be taken into consideration are the regional costs and the minimum wages in each locale. As you know, the City of Los Angeles has a very high also, as well as Los Angeles County. They're also very high cost areas. The ages of the children served to account for not only the child adult ratios, but the number of children served in each classroom.

Title five centers have higher stricter ratios that increase our staffing costs where it's different for family childcares or unlicensed care, reimbursing on enrollment instead of attendance. Centers need to be fully staffed to meet their enrollment ratios regardless.

So if three children show up, we still have to pay for the whole classroom to run and utilities, everything are still included. And some centers are open from six in the morning to 06:00 p.m. at night.

So those staffing requirements are a lot higher than if it were a shorter period or for different models. Again, there are a lot of other aspects to this, but I do appreciate the time to highlight those few.

The last one I'd like to highlight is subsidized direct contracting programs are mandated to perform child assessments, observations, and different aspects of quality that are tied to their contracts. They are not reimbursed, they are unfunded mandates.

And so part of this support should also be, and I know it wasn't included in the survey. They went out was technology costs and the cost to buy the software to run the assessment, the classroom monitoring, tech support, and the training that is required.

There is constant turnover in ECE programs, so having to constantly retrain the field is vital to provide quality to the field and to the children that we serve, and it affects our most vulnerable learners in California. So it is essential we provide them with quality. So thank you for the opportunity to speak today. I appreciate the opportunity to wrap my spiel up.

What are title five?

Title five contractors are the CSPP and CCTR, the California State Preschool Program and the California Child Care Program. And so we are required to follow title five requirements, which are the higher. They're higher than title 22 requirements, and they're a bit stricter on what we have to provide.

And there's no reimbursement for the increased.

There isn't a difference between.

Okay, could you talk to me? You reminded me of this issue was brought up earlier this year. Providers who need to close for lunch or pay time off or non pay time off and how that impacts their rates or just like, their function.

So for staffing, we have to maintain our ratios at all times. And this includes taking children to the bathroom. So if we pull a teacher or adult to move from a classroom to a bathroom, we have to have an extra adult to send with them.

So our staffing requirements for lunches, for breaks, all of those things, we still have to maintain appropriate ratios if one child is awake during nap time. So there are significant challenges to being able to stay within ratio. But we do it myself, I've been on the floor in classrooms in this month because we make sure we run our ratios at all times.

Director, would you say, or even Kimberly, anything that you heard right now was not in conversation during the past six months in negotiations.

All of those items she listed were of consideration are things that we haven't taken into account. I think the title 22 is often like in title five is how they look at rates. It's those regulations, those additional requirements.

And that was kind of the disconnect we had with the family, friend and neighbor because they're not held to those, but those were still included in the conversation and how they were compensated. So I think the structure does allow for those nuances.

Yeah, I'll just add again that as we're looking at the cost model and then actually looking to set rates, the program types to the points that are being made will be considerations. The requirements and standards are considerations. So how it works today.

We have two different rate structures, right. We're moving to a single more simplified structure, but we have a standard reimbursement rate and a regional market rate. And the standard reimbursement rate is what supports title five programs that were referenced.

These are basically programs who have a direct contract with the state to serve a certain amount of youth, right. As opposed to a family receiving a voucher and then choosing where they use that voucher. So all of these considerations are part of the considerations.

And I appreciate the lifting up of technology as well in terms of additions to the survey that was referenced here, but certainly part of the considerations of the cost of care of the varying types of programs we have across the state.

Thank you. My final question, Jackie, you mentioned that it's still going to take some time after the ACF approval. Do we anticipate, did you say next year we could potentially see the rates kicking in?

The Federal Government requires the state to begin to base their rates on the alternative methodology by July 1, 2025.

Okay.

How that looks like, how that's structured. Of course, those details would need to be negotiated in part with the union, but then also again for center based. There needs to also be that concurrent annual budget process.

Perfect. Colleagues, anything further? Thank you everyone. I appreciate it. We're going to move on to public comment on this issue. If anyone would like to provide a public comment on issue one, Child Care Rate Reform, please step forward.

Good morning. Sara Bachez with Children Now. Thank you so much for the discussion. As an organization that represents the best interests of students, we just want to make sure that the state plan has inclusive language centered with an equity framework using a cost analysis model rather than the regional market price, which was good to hear that that's not under consideration with regular cost studies and adjustments for cost of goods and services as they increase.

We've recognized that cost of living, minimum wage loss change and vary through each of our counties. And so for us, it's really ensuring that we have an appropriate and respectful compensation package for our providers, ensuring that there is a transition plan either as part of the alternative methodology or as a separate state document that outlines how and on what timeline the state transitions to the current funding rates, ensuring that our providers are not discouraged. Thank you so much.

Thank you so much. If you can, please keep our comments to 1 minute.

Good morning. Thank you for having us here today. My name is Justina Urpelding and on behalf of our members of over 6000 that are part of EveryChild California and our ECE Voices program, I want to say thank you for all of your support of the ECE community during this legislative session, and we respectfully ask that you please support the new rate reform methodology based on the true cost of care. Thank you.

Thank you.

Hi, my name is Fricia Moore. I own two title 22 preschools in Elk Grove, California, and this highly impacts my ability to be able to pay my teachers. So I support this.

Thank you so much for coming.

Hello. Good morning. My name is Nina Buthee. I'm the Executive Director of EveryChild California. We are in full support of the cost of care alternate methodology, including all of the elements that we discussed today. Early care and education programs are critical for our state in order to move forward, and we think that all of our providers should be compensated appropriately. Thank you.

Thank you so much.

Good morning. Chair and Members Raquel Yaffe with Thriving Families California. Thank you for making time on today's agenda for an update on the care rate reform. TFC has some concerns, focusing on the lack of transparency in the process and issues being discussed so far.

Additionally, TFC has concerns surrounding the lack of conversation to date, recognizing that if a new rate structure is not actually implemented by June 30, 2025 then we will revert back to reimbursing family childcare providers based on a 2018 market rate survey. Thank you for your attention to the concerns raised and we look forward to working with you on these issues.

Thank you.

Good morning, Committee Members. Heidi Kaiser, Director of government affairs for Child Action in support of a true cost based reimbursement rate.

It breaks our hearts to see care facilities close down due to an antiquated reimbursement system for early educators, parents and childcare providers need this change now. Thank you so much.

Thank you.

Hi, Jennifer Greppi with Parent Voices California. And we are in solidarity with all of the care provider United Members on a true cost of care model. And we just want to make sure that we really stay focused on making sure that we meet all of our timelines when parents or providers don't turn in their paperwork on time or don't do what's asked of know, they get cut off of services or they lose their subsidies.

And so we're just asking that the state meet their required deadlines and that we keep on track. Thank you.

Morning, madam chaired Members Andrew Shane and child Poverty California.

Absolutely. Thank you.

I'll align myself with the comments made by Jennifer Greppi from Parent Voices and in solidarity with CCPU, lifting up the need to support family, friends and neighbors. Thank you so much.

Thanks, Andrew.

Good morning. Childcare providers are dedicated professionals who should be paid fairly and supported for their knowledge, experience and talent. I'm Laurie Furstenfeld, director of legal advocacy at the Care Law center.

We are in full support of paying providers in full based on the alternative methodology, by not giving childcare providers respect and fair pay. California policymakers uphold discriminatory laws that exploit black, Latina and immigrant women.

We urge the Legislature to move care programs from merely surviving to thriving, and communities will become healthier and more vibrant now and into the next generation. Thank you.

Thank you.

Good morning, Madam Chair and Senators Rosanna Carvacci Elliott here on behalf of the Early Care and Education Consortium, which is a nationwide nonprofit, and the members here in California operate 475 centers with capacity to serve over 67,000 children.

I want to thank the Committee for holding this hearing. As you heard from some of the other public comments, it is great to have an update for the public that aren't at the table to participate and hear what is going on.

You also heard a lot about the importance of getting this done in a timely manner. I really want to reiterate that, as I think it was Ms. Greppi mentioned about going back to the 2018 rates that can't happen. Certain providers will not be here in existence if that does happen.

And then I just also want to generally align my comments with those of Dr. Lawanda Wesley, who is here on behalf of the ECE coalition. Thank you.

Thank you.

Chair and Members Kathy Mossberg, representing the First Five Association, want to thank you for the hearing and want to align our support and comments with those of Dr. Wesley as well, and the larger ECE coalition. Thank you.

Thank you.

Good morning. Chair Menjivar and Members, my name is Juliet Terry. I'm a government relations specialist with the Childcare Resource Center. I'm here to align my comments today with those of Jennifer Greppi, of Parent Voices, those of the ECE Coalition, and those of CCPU. We are in full support of the alternative methodology and just really urge the Legislature to do everything possible to keep the established timeline for providers.

Providers have waited decades on decades for fair pay and equity, and they simply can't wait another year longer for pay justice.

Thank you so much. Seeing no one else, we're going to move on to issue number two on the proposed delays to safe and housing disability advocacy programs.

Let's talk about some housing snd seniors can have a full house here as well. And we have someone joining us from Zoom as well. Dr. Kushel, welcome.

Hi, thanks for having me. Are you ready for me to start?

Give me 1 second in here.

Sure. I'm sorry I can't be there in person.

Are they going to put her up there?

Yeah.

Are they going to put her up there? I'm sorry, are they putting her up there?

We're being streamed, so I don't know.

Okay, well, Dr. Kushel, welcome is joining. There she is, perfect. Is the Director of UCSF Benioff Homeless Housing Initiative. Welcome, Doctor.

Thank you so much. I'm sorry I can't be there. Good morning, Chairman Menjivar and Members of the Committee, Margot Kuchel, Professor of medicine at UCSF where I direct the Benioff Homelessness and Housing initiative. I'm also a practicing physician and an NIH funded researcher. Today I'm going to talk about the older adult homeless population in the state. So, as you know, on a given night in 2023, more than 181,000 people experienced homelessness in California.

We have 12% of the nation's population, but 28% of those experiencing homelessness and half of those experiencing unsheltered homelessness. But one of the fastest growing groups of people experiencing homelessness are those aged 50 and older. We conducted research in the early 2000s that showed that about 11% of single homeless adults in San Francisco were 50 and older. But by 2023 and 37 percent were. My team recently conducted a large representative study of homelessness, the California statewide study of people experiencing homelessness.

And we found that among single adults experiencing homelessness, nearly half are now 50 and older. The risk of experiencing homelessness for older adults does not fall equally across the population. In Caspa, 31% of older Californians experiencing homelessness identified as black, despite only 6% of older Californians, in the general population. Among adults 50 and older who experienced homelessness, 41% had never been homeless before the age of 50, not even for a night.

Those older adults who had been homeless before 50 and continued after 50 had had devastating childhoods and then lived by marks lives marked by trauma and struggle. But those who became first homeless after 50 had very different stories. They had lived typical lives and had worked physically demanding low wage jobs throughout their lives until something disrupted them

in late life. That was typically either they or their spouse lost their job, they or their spouse became ill, their marriage broke up, or their spouse or their parent died, and suddenly they found themselves homeless. Underlying this crisis, whether it is for people homeless for the first time or those later in life is the housing affordability crisis. We found that the median monthly household income of older adults in the six months prior to this episode was $920.

With the median rent of a one bedroom apartment in our state exceeding one $1500. Affordable housing is out of reach for many older adults. In California, we have only 24 units of housing, affordable and available for every 100 extremely low income households. We are 1 million units short.

But whether new to homelessness or homeless for a long time, those 50 and older have health status more similar to people in their 70s and 80s, as measured by key indicators like mobility, function, cognition, and problems like falls and incontinence. Almost a third reported two or more difficulties with activities of daily living. A third reported mobility problems, and over half reported their health was fair or poor.

These are devastating indicators, and this leads me to say, when talking about homelessness, 50 is a new 75 once homeless, we have found that adults older adults have difficulty exiting homelessness and most, even those who first enter after the age of 50, become chronically homeless. Our research has found that 80% of older homeless adults regain their housing within a few years, but half return to homelessness within a year after regaining it. What protects against this return? Having a subsidy.

Homelessness is devastating to health, and older adults experiencing homelessness have high risk of mortality, three and a half times that of the General community. Among those 15 older, the median age of death is 64, and cancer and heart disease are the most common causes of death. Those first homeless after 50 have an even higher risk of dying compared to those first homeless before 50, and those who regain their housing immediately and drastically cut their risk of death. The status quo is not acceptable.

To solve older adult homelessness, we have to dramatically increase the supply of deeply affordable housing, and we need to center racial equity. We have to focus on prevention, keeping those who are at risk of homelessness from becoming homeless, and preventing those who have recently exited from returning to it. We need to align our systems to meet the needs of this older population. We have to embrace housing first, which is a flexible solution that acknowledges that housing is central.

By providing permanent housing options with tailored, supportive services that are voluntary and meet the needs of this population. We have to be more flexible and nimble in how we use Medicaid, home, and community based services to provide the critical personal care support needed. Recognizing that those who experience homelessness may not be able to navigate our current systems, and we need to provide voluntary behavioral health supports that meets the distinct needs of the older adult population. The aging of this population presents us with stark choices.

We can't be complacent and allow our elders to live and die on our streets. Thank you.

Thank you, Doctor, and I apologize. Correction, you're from UCSF. We're going to move towards our Department. Our Chief Deputy Director from CDSS has joined us.

Claire Ramsey yes, thank you, Madam Chair and Senators, for having me here today. My name is Claire Ramsey and I'm the Chief Deputy Director of the Department of Social Services, and I'm here to talk about three of our CDSS housing programs. Under this first issue, I will be talking about both our HomeSafe program and our Housing and Disability advocacy program, also known as HDAP.

I was asked to provide a brief overview of both programs, which I'll start with, and I'll also be giving an overview of recent data trends, which show our impact and outcomes, some key achievements, and then also was asked to discuss the proposed delays in the Governor's Budget. So I just want to flag that there is a good overview of the two programs in the agenda today.

So I'll just highlight that HDAP was established in 2016 and it has the goal of assisting people experiencing or at risk of homelessness who are likely eligible for disability benefits by providing both housing supports and disability benefits advocacy. There are four key components to HDAP outreach, case management, benefits advocacy, and housing support to eligible individuals. We currently have 57 counties participating and an additional 17 tribal grantees as of FY 22/23.

I'll just note that our tribal grantees include both federally recognized and non federally recognized tribes, tribally led nonprofits, and other tribal organizations. HomeSafe was established in 2018 and it serves older adults, 60 and over independent adults, 19 to 59 who are eligible or apparently eligible for APS adult protective services or who are served by a tribal social services agency who appear eligible for APS who are experiencing homelessness or at risk of homelessness.

Grantees within Homesafe, there is a number of strategies we use to prevent and stabilize housing for APS clients, including case management, financial assistance, legal assistance, and deep cleaning. Right now, all 58 counties are operating a home safe program, and we have awarded 23 additional tribal grantees in fiscal year 22/23. We were asked to describe what makes these programs unique. So I think the power behind both these programs is really the bridge between housing and social services and meeting people where they're at.

We think that by integrating our programs with broader social services, we're ensuring active involvement of the social safety net, which is helping to provide housing stability for older adults and people with disabilities. As I mentioned, Homesafe is integrated with adult protective services, and so in this case, as Dr. Kushell mentioned, often a life crisis can be a precipitant to homelessness, often homelessness for the first time after 50, and often those individuals cross paths with the APS system.

And so there is a moment of intervention there that can happen when it is paired with Homesafe. In the HDAP program, we're really supporting older adults to help them increase their income and to have stable income, which can help them achieve housing stability by making sure that they can consistently pay rent and that they're also getting their housing supports recognized as they're working through that disability process, which can be quite lengthy.

Also want to flag that these programs are uniquely flexible and that really allows each of our grantees to meet their eligible participants where they're at. So it can mean some people might need help with arrears to prevent them from losing a housing placement. Some people might need help with a down payment or first month's rent for an apartment, or help to buy furniture. And those things are all possible with the flexible dollars within our two programs.

I now want to address the question about impacts of the investments. So, as I know you're all aware, we had very significant one time investments in both fiscal year 21 and fiscal year 22 for both HDAP and for home safe, and these dollars were made available across multiple years. So HDAP once started serving people and through June of 2023 we have had 3,345 people permanently housed through our program. 9,318 disability applications have been submitted on behalf of participants and 1,881 disability applications have been approved.

After six months after exiting the program, we are seeing 84% of participants retain their housing, which, as Dr. Cachell mentioned, is a significant marker of attaining housing stability and a thing we're looking at very closely because we want to make sure that this is not a temporary solution, but a permanent solution. HDEP has a 68% approval rate across all disposed disability benefit applications, and just for comparison, the average rate of approval for those benefits is 35%.

Just want to flag that we often have HDAP participants stay in our program over multiple years because the disability benefit application process can be lengthy and can involve multiple appeals. Participants can stay in the program while their disability application is pending and being worked on through appeals, and then they can continue to receive the housing supports while they stay on the program over multiple years. Another indicator I just want to flag is that we really have seen HDAP increase collaboration across key systems.

We had surveys out and 98% of our grantees report that they are working with health systems as part of their HDAP work, 88% that they are collaborating with the in home supportive services system, and 88% collaborating with public housing authorities. So we're really pleased to see that again because we're integrated with social services, that HDAP is really reaching across systems and not staying siloed. And then finally, I would just like to flag a couple of outcomes at program exit.

We are seeing and we have released a report we're calling the AB 120 report because it was required of us in last year's budget that 41% of our participants in HDAP are exiting to permanent housing in fiscal year 22/23 and we want to continue with those good numbers and keeping people working through the program into permanent housing. I'd like to share one HDAP success story.

A 57 year old man came into the HDAP program facing a situation that many older adults who experience homelessness for the first time struggle with. He had become too disabled to work and could no longer afford housing. He initially declined to pursue disability benefits, hoping instead that he would eventually find and maintain a job. During the pandemic, he became unemployed and then homeless again.

After moving into interim housing through the regional continuum of care, he was linked to the HDAP program and decided to apply for SSI. He was denied six months later for the fifth time, but although he was prepared to give up, staff encouraged him and together they filed his first appeal. Also in that same month, he was able to sign a lease on his own apartment for the first time in his life and moved into his first stable home in years.

The program leveraged federal subsidies to pay his rent and supported him in meeting basic needs while the SSI appeal was pursued. And then in January of 2023, 18 months after he applied and appealed, this HDAP participant received his disability benefits and his benefits were activated. We were able, through that program, to ensure he received an emergency advance payment of $3,000 to cover his costs while he was waiting for his disability benefits to start.

And he's now receiving $1,113 a month in SSI benefits and he's owed over 20,000 $7,000 in retroactive benefits, which he'll receive soon. And he quoted by saying, I've lived with mental illness for 27 years. This is the first time I've had any kind of assistance. I'm so grateful I am a success story. So we're proud to be able to share that story with you. Now I'll move on to program impacts and outcomes and key achievements for Homesafe.

So, as of June 2023, 8756 people have received assistance through the Homesafe program and we have had 3,555 instances of housing related financial assistance provided. Additionally, we have connected 2,037 people to the local coordinated entry system through Homesafe. Dr. Kushel's and her team at the University of California, San Francisco Benioff Homelessness and Housing Initiative led an interim evaluation of the Homesafe pilot. So if you remember, Homesafe started as a pilot and then when the additional one time funds were added in 2021, the program expanded statewide.

From that initial findings, there was a finding that housing was retained for 85% of participants in Homesafe. Six months after exit from the program, it was found that Homesafe has fostered strong relationships between APS and the larger network of social service providers that make up the continuum of care. And again, it was found that the flexible dollars available in Homesafe were crucial to the program's success. It appeared that at that point, Homesafe was stabilizing clients who would have otherwise become homeless. In FY 22/23,

CDSS has continued its partnership with UCSF to further evaluate Homesafe and we anticipate evaluation findings to be published in early 2026. So we will have another evaluation now that the program has been running longer and is broader throughout the state. Homesafe grantees also report to CDSS that they have strong collaborations with other programs, 96% are collaborating with in home supportive services and 74% are collaborating with their medical managed care plans, again highlighting some outcomes.

We've also highlighted that in our AB 120 report we are seeing that approximately 47% of participants are exiting from home safe to permanent housing in 22, 23 and we also want to share a story from Homesafe from Butte County, and I apologize. Our HDAP story was from LA County from Los Angeles County.

Can we actually move on to question number three?

Sure. So we were asked to discuss the proposed delays of $50 million in HDAP and $65 million in Homesafe that is proposed to be implemented in 2024/25. We were asked how it would impact local programs and whether CDSS impacts, excuse me, anticipates that any local home safe and HDAP programs would close or scale back if funding is withheld by one fiscal year. So thank you for those questions.

First, I would like to clarify our intent behind these delays and make sure there is no confusion about what we're trying to accomplish here. First, to clarify to implement the proposed delays, we are seeing this as a reappropriation of the 22/23 funds into the 2526 fiscal years. So simply, we are extending the timelines for spending those one time dollars in 22/23. We are not intending through this proposal to negatively impact these programs or disrupt service delivery.

The data we use to identify the $50 million in HDAP and the $65 million in home safe were based on point in time information that we have and that we recognize we may need to make adjustments in may revision. So we are currently evaluating our data. As I think we've mentioned in previous hearings, our claiming data comes in fairly in arrears from the actual spending by the grantees. So we're always playing a little bit of catch up to understand actual expenditures in the program.

But we are looking at that data so that we can evaluate and have better numbers in may revision to present to the Legislature. We are also aware that this impact, or, excuse me, that we don't wish to impact any of the programs by delaying funding into 25/26 and that we likely will have unexpended funds that can be delayed statewide.

However, we want to acknowledge that that may not be true in every single county and every single locality, so that we are working closely with the County Welfare Directors Association and with counties to understand what their local impacts may be and to determine whether we need to take any actions to mitigate negative impacts from these delays for those particular counties. I will stop there, but just want to make sure it's clear that we really are wanting these programs to continue.

We want the good work of grantees to continue and we believe the delays can appropriately save the state money in 24/25 while allowing the programs to fully expend the one time dollars into 25/26. Thank you.

Thank you so much Chief Deputy Director. Moving on to Department of Finance, can you tell me how to pronounce your first name?

Good morning chair, I'm Idalis Betis from Department of Finance.

Thank you.

HDAB received a total of 300 $1.0 million General Fund over two years beginning in the 2021 budget. Additionally, HDAP received $25 million General Fund ongoing since the 2019 Budget act. As for Homesafe, the program received a total of $185,000,000 General Fund over two years beginning in the 2021 Budget Act. Both programs onetime appropriations are match exempt, which means counties are not currently required to contribute a dollar for dollar match guarantee for these funds. As reflected in your agenda,

The AB 120 HHD annual report shows that based on June 30, 2023, in time estimates, the total remaining amount of onetime funds for HDAP is $177,000,000 General Fund and Homesafe is $127,000,000 General Fund. The intent of the Governor's Budget proposals for HDAP and Homesafe is to align the authority with how counties are using their funds. The amounts to determine these shifts in funds are based on point in time data and county and tribe spending trends.

This will overall help counties have an additional year to spend these remaining funds for the programs. We will assess as necessary if there are any updates to these point in time expenditures.

Thank you so much. Now moving on to Kelly Carpenter, who's a program manager of adult services in Nevada county.

Good morning Madam Chair and Members. I'm here to just give a brief summary of the home safe program at the county level. Nevada county was part of the original pilot in 2019 and Nevada county is rural with a population of about 103,000 with 37% of the population being over 65.

We developed our specific home safe criteria checklists, program intake flowcharts, and attended all of our local community partner meetings to collaborate with our homeless outreach team, our aging and disability resource centers, hospitals, and our Behavioral Health and Social Services Department. And we actively have worked with them for the last five years and braided our funding together to support our community.

We also met with our fiscal Department to share the program details and verify the realistic timing to make sure that we were able to provide the support at the county level, and they committed to a two week turnaround time on being able to issue checks to help our clients. We manage the Homesafe program in house with our current APS team of two, and all of the APS cases and Homesafe cases are reviewed by myself as program manager and the supervisor of my team for payment authorization.

Homesafe has been a game changer for us. It really has. Being able to make needed community referrals to retain housing and have the funds to assist our clients is truly meaningful support. Prior to Homesafe, our APS social workers were able to offer community referrals to improve their situation, but most often the clients didn't have the resources to pursue the referrals. During our Homesafe funding streams, our counties experienced significant winter storms two years in a row, and also Covid was thrown in the mix.

We served 253 clients with Homesafe. We assisted 128 clients with new housing or sustained housing. We assisted 125 clients with housing related support, wraparound services that would be handicap ramps, hazard removal, mobile home roofs, hoarding cleanup. We received approximately $158,000 and our average cost per client was about 2,200. The average client served was 65 years of age, and 58% of those folks were female and 42% were male. I wanted to circle back on meaningful support and share a story, an APS story.

We had an elderly woman who was living with her mentally ill son, and he was using her money and kind of had taken over her home. During one of his mental health breaks, he doused her with vodka and attempted to light her on fire. Thank goodness she was able to get to her cell phone and called for 911 services, and he was arrested on the scene. So prior to Homesafe, we would have been able to offer her victim witness support and counseling.

But with Homesafe support funds, we were able to offer those things as well. But also we were able to pay her back rent, change the locks on her mobile home, and cleaned up her home. I mean, that was truly a success story for us. So Momesafe funding at the community level is so very important, and Homesafe is meaningful support. Thank you.

Thank you for sharing that story. I'm joining us from the San Francisco Human Service Agency, Susie Smith, Deputy Director of policy, planning and public affairs.

Hi. Thank you for having this panel. I just want to start, so we're going to talk a little bit about HDAP, what we've been able to do here in San Francisco with the expanded funding and what the impact on a one year delay in funding would be. Just want to start by reminding us, the HDAP program, it's serving people who are disabled and homeless, so a pretty vulnerable population.

We have found that HDAP has proven to be an effective multi year strategy to moving people who are disabled and homeless into housing, as well as accessing medical care and a steady stream of income. It takes time to take root and see the outcomes. As other people have mentioned, getting SSI can take here in San Francisco, on average about 18 months. I know elsewhere it's much longer than that. The expanded funding has been transformative for us in two ways.

One, we've been able to double the number of people that we serve in San Francisco, and secondly, it's enabled us to develop an entirely new model where we now have a multidisciplinary team that goes from shelter to shelter, helping people experiencing homelessness enroll in a variety of services. We have a team of nonprofit and city workers who screen people for eligibility for permanent housing.

In these shelters, we help with benefits applications, so Medical, Calfresh, general assistance, and we screen for HDAP and home safe again, bringing all of these services directly to the people in need. Since the expanded funding took effect, we've been able to visit 21 different shelters and navigation centers across our city, enrolling them in these variety of benefits, and we have outcomes that we can be proud of. We've supported 235 disabled homeless folks through this program.

We have an SSI award rate of 77%, and as was mentioned earlier, the national average is 31%. So we are giving again homeless folks who are disabled the steady stream of income. In terms of housing. Our social workers help HDAP participants through the complicated process of securing permanent supportive housing. Even if you are prioritized for that housing, it takes time and intensive social work and navigation to actually get into that unit. 75% of our HDAP participants are now permanently housed.

And again, this is through the expanded funding, which was five times the amount that we had gotten, from 1 million to 5 million. So this is providing real, direct, real time access to these supports. It's enabling us to maintain relationships that then help us build the SSI advocacy case and enable us to be successful. I have a success story I can share.

So I wanted to share the story of Johnny, a 43 year old man who had been assaulted multiple times, living on the streets and in shelters due to traumatic brain injuries. He was one of the highest utilizers of Sf General hospital emergency care. His brain injuries made it difficult for him to communicate. But through the support of the HDAP social worker and legal team, he has been able to develop a positive relationship with his Doctor, who he sees monthly.

He's seen a neurologist and is getting regular speech therapy and occupational therapy. And because of that positive relationship with his Doctor, that was through the connection of HDAP, he no longer uses ver as his primary source of medical care. So there are these other systems level impacts, which I think is really important to mention. And that connection to medical care enabled us to build the SSI case.

About a year ago, his SSI case was awarded, and shortly after he moved into a quiet supportive housing building where the on site supportive services has enabled him to maintain housing stability. So what is the big deal about delaying our funding for one year?

Right?

That's the question about this hearing. And so I just want to share kind of what that means locally. So for us, our next year's budget, our FY 24/25 budget would be reduced by $2.8 million, which is almost 80% of our budget. Next year, our contractor or Bay Area legal aid, their FY 24/25 contract would have to be reduced by two thirds. We'd have to stop new enrollments. So we were looking at about 70 disabled homeless adults that would not be able to be served.

So there is a real impact in terms of stopping enrollments. I want to be really clear on that. 30% to 40% of our existing clients would be in jeopardy of losing legal representation and social work support, which is against the legal and moral obligations when an attorney takes on a case. As I mentioned, it's a multi year program, so having funding that sort of stops and then starts and then stops again makes it really difficult. With the increased funding, we were able to ramp up quickly.

To meet the need, our nonprofit partners hired staff who needed to be onboarded and trained, and it's a significant investment in the first year of a program. If they had to reduce the staff next year due to this big decline, what they've told us is they're unlikely to ramp back up again. A nonprofit can't just increase funding by two thirds, decrease by two thirds, and then increase. You can't run a program or an organization that way.

So it provides a difficulty in a program, a strategy that is multi year, and it provides uncertainty for both participants and staff. And so we would see a disruption in services. At the same time, I don't envy any of the Members of the Legislature having to make the difficult decisions that need to be made this year to close the deficit.

I know that CWJ is working with CDSS and counties to try to figure out whether and how a delay would be operationalized and what amount of funding would actually be delayed in the end.

But I guess one of the questions or requests I have is looking at reallocating, underspending, and seeing where there are direct impacts, and trying to mitigate that by looking at counties that weren't able to use the money as effectively, and also looking at whether a lesser amount can be delayed because a two thirds impact for our providers, almost 80%. I didn't talk about the impact on our staff, I was just talking about the riders. But an almost 80% cut in one year has real impact.

And so maybe there could be a less severe version of this. Happy to answer any questions. I'm sorry, I think I went over five minutes.

Thank you so much. Next up is representing justice and aging, Patty prune Hoover. All.

Thank you. Good morning, Chairman Menjivar and committee members. My name is Patty Prunhuber. I'm the Director of Housing Advocacy at Justice in Aging. I want to thank you for holding this hearing as well and inviting me back this year to speak about the impact of the administration's proposed delays in funding for the Homesafe and Housing Disability and Advocacy, as we call it, HDAP programs. You know, Justice and Aging is a legal advocacy organization.

We use the power of law to fight senior poverty, ensure access to health care, economic security, and housing to advance equity as we age. We're also deeply involved in implementing the California master plan for aging so that every Californian has access to the housing, healthcare services, and supports, and economic security to thrive as they age. And these two programs are a key accomplishment and goal of preventing and ending homelessness among older adults and people with disabilities, and have been touted as part of our success.

We are concerned that Homesafe and HDAP are the only two statewide programs that exist to specifically meet the housing stability and service needs of older and disabled adults who are at either imminent risk or currently experiencing homelessness. I want to hearken to Dr. Kushel's excellent overview of what is happening with older adults and homelessness. And I have also given you our paper, hot off the press, on how California's older low-income renters are being squeezed by housing unaffordability.

And that is what is driving this age group being the fastest growing group, aging into homelessness. And we shouldn't be saying those words together, aging into homelessness. So the proposed funding delays are not going to be without a lot of pain.

The delays of 65 million for the Homesafe program and 50 million for the HDAP would force counties and tribal entities to severely curtail their housing stability and homeless prevention services currently provided to this population, and to do so at a time when adult housing instability and homelessness is spiking. So there's been an excellent background on the Homesafe and HDAP programs provided to you in the agenda and by Chief Deputy Director Ramsay. And you've heard great testimony about how these programs operate in individual counties.

I just want to give a little more picture of how this ramp-up that happened in 2021, and I think counties have described how it takes time to absorb the good funding increases and to build systems, and so local programs work to ramp up each of these programs. But it took a while to hire staff, assemble multidisciplinary teams, sign contracts with homeless service providers. And the more recent numbers that Director Ramsey gave really give you a picture of how many people are being served.

It's a drop in the bucket. I would like to be here asking you to expand these programs. I know that's not in the budget cards for this year, but that's what we should be doing to address this crisis. So what is the impact of delaying that funding? First, I want to point out that that point in time data that was used by the department is really important, but it has two lag times.

It is that the county's delay in being able to submit claims for reimbursement, but it also was done as of June of 2023. So we're a year behind, plus whatever lag time is happening as a result of bureaucracy. And I think that we will see that there are about nine counties, including San Francisco, that are scheduled to run out of their money at the end of this year. And so without additional funding or a reallocation, we are going to see cutbacks.

There's just no way around it. And this has been touched on. I'll just mention it. The uncertainty of continued funding really threatens to curtail the progress we've made. At a time when homelessness is growing at an alarming rate, we shouldn't be cutting back these services and then ramping up again when the budget picture is better, has its own problems. So for Homesafe, which is the program I work with most closely, there was no Homesafe funding in the last budget year.

So counties have already been asked to use the two years of funding they got in fiscal year 21 and 22 to cover fiscal year 23 expenditures. And so now they're being say, oh, no, use it another year. But there is no new money. I just want to make clear that it's not as if there's another expenditure that's going to be applied.

And the total two-year allocation sent to local grantees, which was, as people said, transformative, was about $166,000,000, as somebody mentioned, 85 million in each year. But a certain portion stays with the department for their Functions. So a $65 million delay stretches the total dollars for an additional year and represents a 39% reduction in funding that goes to the counties just when these programs are reaching full operational capacity.

I mentioned that there are counties that are running out of their money, and for that reason, Justice in Aging would support both, trying to use current data to reflect what's really left available so that it isn't a cut, but also to support the department having the authority to reallocate unspent funds among the counties. For those counties that are more likely to run out of money in this next fiscal year.

Any final thoughts?

Yeah, thank you. I just want to point you to this report which really points out that the number of older adults seeking homeless services has more than doubled in the last six years. We have a crisis that we need to address, and the final point is that we have a return on investment here. When we invest in homeless prevention, when we can get people housed, when we can get them on disability benefits, we not only increase the success on those claims.

When high utilizers of services go from unhoused to housed, that results in cost savings through reduced ER visits, hospitalizations, psychiatric hospitalizations, lower rates of reincarceration. And we will inadvertently cause expenditures in other areas in addition to the human tragedy of it if we do not keep these programs going. Thank you very much.

Thank you, I appreciate it. LAO, Juwan.

Juwan.

Juan, any additional comments to add to this?

Yes, thank you, Madam Chair, Senators. Juwan Trotter with the Legislative Analyst Office. So in going through these delays, these proposed delays, one of our main questions has been how much funding will be left behind for expenditure in the budget year. So, for example, will this leave enough money to maintain current service levels, or will current service levels need to be reduced to reflect the reduction in funding?

And so, as has been mentioned, if the intent is to leave enough funding to maintain current service levels, will this also be reflected on a county by county basis, as the agenda has indicated, not all the funding for this program has been spent to date, and it is our understanding that funding from previous budget allocations does remain to be spent in budget year.

And also, as also has been mentioned previously, we also acknowledge that these revised or these delays are a reflection of point time data and that these will be revisited as we get closer to may revision. And so we think that that would be a good time for the Legislature to get a better understanding of the budget funding levels on a county by county basis. Thank you.

Thank you so much. Let's start with that last point. I know you mentioned that there are some counties that have utilized more of their funding and others that have not. We've heard from one of them that would run out. Are we looking, you spoke a little bit to this, looking at a model where we're reallocating it for the ones that are going to run out this year to potentially make them survive another year.

Thank you for that question. Yes, we are having conversations with CWDA and the counties about what is possible. We refer to it as redistribution, but between counties who may be some getting close to hitting their limit or spending down their entire allocation. And other counties who did take longer to ramp up, who may have more money that could be shifted over. So we are looking at that and we are looking to have our data through the end of last year.

So through the first two quarters of the 23-24 year, and we've shared some data with the counties so we can start to look at what is available between counties and where some counties may have underspent and where counties are at risk of running out of money.

I mean, Patti, I'm so glad you brought up the master plan on aging because that's key here. Right? Goal one is housing. And I even wrote goal one, initiative three address housing needs access to integrated models, able to remain in homes and community, and HDAP and Homesafe program does just that. And I'm glad that we're getting some reports on analyzing these programs because that's also part of the master plan on aging. On go five, initiative 88 specifically talks about Homesafe and HDAP.

And having analyzed the success of the stories and hearing stories from you, hearing stories from the counties, this is a very extremely beneficial program that is really going to help with this silver tsunami that we're going to be seeing in 2030 and finding a way, I know you mentioned this is a tough year.

I think someone said you don't envy us being in a position to come cuts, but this is a program that there is some funding left in there where we can be magicians here and find a way to spread it across the state at different counties and not essentially impacting projects. Because in other things we've talked about, the uncertainty of stop go, stop go really impacts our CBOs from adequately providing these services, the uncertainty of it all, right.

But it sounds like we're going to potentially find a way to be able to come to a way to make these programs last a couple more years with the funding that we have available and still be able to delay and save some funding on the unutilized funds.

That's exactly right, Chair Menjivar. That's our intent and our goal here. And again, we do think we'll just have a better sense of all of this that May revision and so agree with LAO's analysis that we'll be able to have a more in-depth conversation then.

To the two counties here. If either of you would like to answer this. You gave me some percentage of great, the ability, 84% of people are retaining their homes. We have a 68% application approval rate. And then I believe, Susie, you mentioned 75% main stay within their homes. What barriers do exist? I'm looking at this, if I was in a classroom, great numbers. It's still C, right. What barriers exist to get to a B, A minus of retention in homes?

The 75% that I mentioned. Not everyone has been placed in housing yet, so they're still in process. But I will say some of the challenges we've had HDAP clients pass away before they got their housing. We've had HDAP clients that do lose contact. I mean, we are talking about, even with the most on-the-ground multidisciplinary team in community, this is a difficult population, and sometimes we do lose contact with folks.

But if you look at the average of this intervention versus others, in terms of making consistent connection, it's very successful. And the other thing I just want to add, we planned because we knew we could carry forward up until this point, the extended funding. We planned over a four-year period. So it's not that we don't have unspent dollars, we do have unspent dollars, but we were able to, up until now, we could carry forward that 2.8 million.

So part of it is like, counties are planful and nonprofits are planful. So we look at, we want to stretch that. We had a two year spike in funding that we stretched over a couple years. So I just want to be clear. There may be unspent funding, but we counted on that for next year. So that's the difference.

And I think sometimes the LAO, not understanding that nuance, like we looked at, okay, if we have two years to spend the funding, we don't want to spend it all in one year. We want to spread it out to the two years. So counties might have on paper, if we do it the way we're planning, we would have that 2 million unspent that we're planning on carrying over to next year. We can't carry it over. We now have to wait to another year.

That's that stop and go piece that I was talking about. Does that make sense?

Let's have a little into that. If you, on paper, have some funding to be able to survive the following year, are you anticipating because this would be an impact in six months from now or so for you to stop enrolling people like you mentioned? Yeah, we would have July 12025.

Yes, we would have to. Because we had planned to spend, because we were allowed to carry over that extra funding into next year. We had planned to do so and we would be enrolling another 70 people.

And I can imagine. We have some very smart mathematics and all that. Who can look at what counties have on paper left over and be able to adequately say which ones really will have leftover?

Okay, if I could just answer to that point, we are looking at identifying counties not necessarily that are at 100%, but that are at a percentage, high percentage that we project would spend out the full amount, even if on paper they're not showing. So we are accounting for that planfulness that you were talking about.

And so the other thing I just want to flag, because this is something that I think we were not able to be as clear about before this hearing, is we are proposing reappropriation as a mechanism to extend these funds, which means that San Francisco would not have to hold back its funds in 24-25 and wait to spend them in 25-26.

It's just that other counties would have the ability, if San Francisco ended up spending out all the way by the end of 25, that would be okay. But if other counties needed that extra year, they could spend it out. And then we're trying to count the savings for the counties that will need the extra year. So we're not suggesting that counties have to take a pause or put a moratorium on spending or claiming as part of this delay proposal.

Okay, colleagues, any questions?

Senator, thank you. Just to also make the point, I mean, aging and homelessness is one of our key issues that we need to stay invested on. And I think especially when someone's nearing the end of their life, any pushes down that slippery slope can be incredibly detrimental.

The LGBT Caucus is doing some rural tours around the state, and we were down in the Coachella Valley this last week and certainly heard a lot about the cost of housing and the amount of seniors down there and the problems that people are having. So this is just one of those things that I know we need to make adjustments, and I'm happy to hear that you're looking at how to perhaps balance that out.

So there's not that stop and go, because that stop and go is going to lose people. Right. We're going to lose people, and they're going to fall off the edge, and we're not going to be able to get them back. Right. There's not time for things like this. And then the medical problems compound. So just to say, I'm glad you're looking at it really hard.

This is something that's going to be, I think, a very hard one to really think about cutting, because I think it's imperative and we got to treat people with respect. Thank you.

Thank you so much. Looking forward to that May revision on more up-to-date numbers and what we have. But I appreciate us finding a way to make it all work. And thank you so much for the hard work that you all do on the great things that you're doing in different counties. Moving on now to, and we're going to hold this item open. We're going to move on to issue number three.

Yes, thank you. Chair and Senators Claire Ramsey for the Department of Social Services here to talk about our community care expansion program, which is really a great segue from the last where we talked about lack of housing and lack of care options for older adults, people with disabilities. Our CCE program, as we call it, is really working to expand the infrastructure available for people, the housing options for people the community care expansion program has two components, an expansion component and a preservation component.

And the vision behind CCE was to expand the state's housing and care continuum for older adults and people with disabilities who were experiencing homelessness and who were at risk of unnecessary institutionalization. CCE is part of our state's key strategic, multi-agency effort to reduce the inflow of individuals into our homelessness response system. And it's another pathway by which our department is trying to advance the master plan for aging goals that we spoke about in the last panel.

Both goal one, housing for all ages and stages, and goal five, affording aging. And we really want that housing to be affordable, age-friendly and disability friendly. The CCE program was funded through one time funds totaling $860,000,000, which has been available over multiple years and was established in 2021.

For the expansion program component we are using of that, $860,000,000, $570,000,000 of that is for acquisition, construction and rehabilitation of adult and senior care facilities that serve applicants and recipients of our SSI SSP program or our Cash Assistance Program for Immigrants, our CAPI program, who are at risk or experiencing homelessness, and a portion of those funds. Oh, I'm sorry, did you. Okay, sorry. A portion of those funds can be used for operating subsidies to help maintain fiscal solvency for the facilities.

Our preservation program has provided $247,000,000 to 34 counties to immediately preserve and prevent the closure of our licensed residential, adult and senior care facilities, including our ARFs, adult residential facilities and our residential care facilities for the elderly, our CFEs. Our intent is to expand and preserve a total of 7000 beds or units throughout the state.

We were asked a few questions on question two, what has been achieved so far, including new beds for individuals on SSI, an overview of the types of residential facilities supported with the CCE funds and the needs of those individuals. How many facilities are serving individuals on SSI that have been awarded expansion grants or operating subsidies? And what has the department learned about the impact of those operating subsidies? So, applications for CCI were accepted through a joint RFA until June 1, 2023.

We received overwhelming interest with 374 applicants requesting approximately $3.8 billion in funding. This is a very hot off the press hearing, so we have a hot off the press item here, too.

We just put out a press release this morning that we have awarded seven more projects in CCE, which brings our total awards to date to $464,000,000 across 55 projects that will expand capacity for an additional 2465 beds or units, and that's in a mix of settings through licensed residential care facilities, recuperative care sites, and permanent supportive housing. And I'll give you some breakdowns of those numbers in just a moment.

We have learned that the operating subsidies really represent a crucial element of this program, and it's really imperative for these facilities to be able to receive that need it to be able to receive the operating subsidies in order to create a sustainable, long-term project. We do know that we have had challenges over the past years with our facilities that serve SSI SSP and CAPI recipients staying open because their margins are just so small.

And they've also expressed to us the challenges they have to keep the properties up and at a sufficiently good level to be habitable. The breakdown of facility types and those receiving operating subsidies. And I can follow up in writing as well for all these numbers, but we have 15 projects that are funded to create 745 beds in adult residential facilities, and four of those projects requested and are receiving operating subsidies, what we call capital operating subsidy reserves or coasters.

16 of our projects are creating 657 beds in RCFEs. So that's for residential care facilities for the elderly, and six of those projects requested and are receiving the COSR funds. 19 projects are funded to create 480 permanent supportive housing units, and five of those requested and receive COSR. We also have two of the remaining projects, excuse me, that are included. Of the recuperative care, respite or recovery residences that were eligible projects, two requested on receiving COSR.

And I just want to mention that those numbers may not perfectly add up because some projects have multiple types of facilities that they're building on the same site. And then to question three, how is the CCE program preventing the closure of licensed residential care facilities and expanding the license capacity. As I mentioned, our goal is to create or preserve 7000 new beds across the state, and we have awarded on our preservation program, $247,000,000 in one-time noncompetitive allocations to 34 counties through the preservation program.

So we put out a notice to all counties. All counties had the opportunity to accept funds and 34 counties are participating. The participating counties are responsible for the administration and disbursement of the funds to existing licensed facilities that are serving the prioritized population and that are at risk of closure. The licensed care facilities may receive either an operating subsidy and or they can ask for both capital funds to make improvements and repairs or physical upgrades to their properties.

And this is again to maintain both the facilities as a high quality for all the residents who are living there. I wanted to give you some updates about what is going on with the preservation program. We now have 22 of those 34 counties that have executed contracts and are moving forward in their next phase. We have 12 that are still in the process of executing their contracts.

14 of those 22 that are already in executed contracts are in the process of releasing their local requests for applications to their local facilities who are eligible. And we have 12 counties that are in contract with at least one facility. So the money is starting to get out into the community now. The next step will be dispersing funds to facility operators. And I just want to flag that we have two counties that are already in that phase of implementation, including Trinity County, one of our rural counties was able to be one of the first ones out of the gate to get money to facilities.

We anticipate as the money starts to go out, we will have additional information to provide. But again, we have anecdotally heard from facility operators.

We've also done some site visits with facilities and heard from them directly about the significant importance of these funds, both to basically make sure that they are meeting their bottom line and are able to be fiscally soluble and also for the upgrades and for the improvements. So there are residential care facilities that have been in business for dozens of years and are family businesses, but really struggle to pay for, like when a hole in the roof happened, when they needed to remodel the kitchens or bathrooms, or to make them accessible so that they could serve more people using mobility devices.

And so we've really heard from operators the importance of these funds so that they can continue to operate for 30, 40, 50 years and continue their family businesses. Just want to say that we are starting to see good trends. We have numbers through the end of the third quarter of 2023.

So when we compare our number of licensed facilities that serve SSI SSP and CAPI recipients, from the end of 2021 through the end of the third quarter of 2023, we have seen an increase of 7.8% of the number of facilities, excuse me, adult care facilities with a 3.8% increase in their overall capacity. And in that same time frame for senior care facilities, we have seen an increase of 9.4% in the number of facilities with a 2% increase in the overall capacity.

So these are the trend lines that we're really looking for and are excited to see continue as we continue to roll out the preservation and expansion dollars. I will stop there, but happy to take any questions.

Thank you. LAO, any comments on this item?

Juwan Trotter, Legislative Analyst Office we have nothing to add at this time.

Department of Finance, Idalys Perez, Department of Finance. Nothing further to add at this moment.

I have a question to either Department of Finance. Ms. Ramsay, you mentioned, great, off the press, hot off the press. 464,000,000 across 55 projects. Preservation program. Approximately 247.7 million. Unless there's an updating number. Pretty good close to the 860. And I know part of that was for HCBS funding. Do we have a number of how much is left in our plans for the leftover, or am I.

Just to clarify your question, are you specifically asking about where we are in spending on the HCBS funding?

No.

Specifically.

No.

On the eight.

I know we had 860 for this, right?

That's correct.

But 53.4 is for HCBS funding.

That's right.

I'm taking out of that. Out of that. The numbers that I have in front of me are 464 that you mentioned, and in the agenda we have 247.7. I didn't do the quick math. Is there anything remaining? Is there plans for that.

Excuse me, I didn't interrupt you. Thank you. Yes, we do have another. And I'm also trying to do the math. Back of the napkin math. $116,000,000 to finish awarding through the expansion grants. And we expect to be doing that in the coming months. So likely before the end of the fiscal year, all the expansion dollars will be out and awarded. The preservation dollars have gone out. That included both the original allocation for operating subsidies as well as the second round of 55 million.

Those have all been put out. And then we also will continue to make sure that there are other components of the program. We have a third-party administrator of the program, which some of the funding goes to them, which are helping to basically administer and disperse all the funds and work with the individual grantees.

Do we have an average for each application, how much we're funding?

We can give you numbers on the total award for every project as well. Are you also asking on how much.

Per bag for the expansion program?

Sure, we can provide a full list of all 55 projects. Is that what you'd like?

Do we anticipate utilizing the entire $116,000,000 that we have left over?

Yes.

Okay, we do. LAO, would you recommend this being a topic that we can put a little bit that hasn't been gone out to pull back to fund other programs?

Ginny Bella with the analyst office. I think, as you've indicated, there's going to be difficult budget choices and our office has said that some of the things you might want to start to look at is money that has not already been committed. This sounds like it fits that category. The money is not out.

I don't know what commitments the department maybe has already made to subcontractors, but certainly if that's something, as you're looking at the whole package of decisions you're making, if that's something that is still on the table, I think it's worth considering. Of course, there are drawbacks. Yeah.

Where are we on that process for the remaining applications?

So we're currently reviewing applications and making decisions on awards and declines on those remaining applications. Obviously, we had far more interest than we can fund, so we do expect to be able to fully expend those funds through the applications we received. I will just note the way the funds were basically structured within the RFA was that there was regional amounts for each of the seven regions. We've broken into seven regions throughout the state.

So there are a couple regions that have not hit their target, which those are high priorities for us to finish those awards. We still have money within the tribal set aside that we are looking at applications within tribal awards. And then there was money that was allowed to be held for any kind of high-priority projects that we were still looking to award through the state set aside.

So I would say respectfully, that although they have not been actively awarded or are not awarded at this moment, we are actively reviewing applications to fulfill the commitment that was put out in the request for proposal.

Senators, any other questions? Thank you so much for that update. We're going to be moving on to issue number four, in-home supportive services overview.

I'd welcome the Administration to kick us off.

Thank you. I'm staying up for the panel, but Claire Ramsey, CDSS. I'm going to let my colleague Leora introduce herself and start.

Good morning, Madam Chair and Committee Members. My name is Leora Filosena. I am the Deputy Director of the Adult Programs Division, oversee the In-Home Supportive Services Program, the Cash Assistance Program for Immigrants, and the Adult Protective Services Program. So I guess we'll just go ahead and get started. The agenda did a great job of really giving a really in depth overview of the IHSS program. I know the question is kind of, can we give a brief overview?

I'll just kind of emphasize a couple of points. The IHSS program provides domestic and personal care services to children and adults with disabilities and older adults to keep them safely in their own homes and communities and avoid institutionalization. IHSS is a very large program. It's the largest program in the country when it comes to home and community based services. It's also the backbone of California's home and community based services programs.

We are now serving over 750,000 authorized cases, and those individuals are being served by over 650,000 providers at this point. We issue over 1.5 million checks each month to providers for those services. IHSS is largely administered by the counties, with oversight from CDSS. County social workers perform an annual in home assessment to determine what IHSS services a recipient needs based on their ability to perform certain tasks.

I think it's important to note that the authorization of these services often means the difference between someone staying in their own home and being institutionalized. IHSS, one of the more unique components of IHSS, is that it is a self-directed program, meaning that IHSS recipients are really responsible for managing their own care.

IHSS recipients are served by providers who can be a family Member, a friend, or someone they do not know that maybe could be on the registry, and the IHSS recipient is considered the employer of that provider and that provider is considered their employee. That's also very unique to California's program. And by saying the IHSS recipient is the employer, they're really responsible for managing and hiring their own provider. Other than program oversight, CDSS is the payroll agent on behalf of the IHSS recipients.

So we do all of the payrolling activities, and we also are responsible for the operation of the case management information and payrolling system, which is a system of record for IHSS. The 24-25 Governor's Budget proposes a total of $22.4 billion total funds in fiscal year 23-24 and $24.3 billion total Fund in 24-25. This is an increase of approximately $1.9 billion.

The increase is largely due to the expansion of the full scope Medi-Cal to undocumented adults, the sunset of enhanced federal Medicaid funding, and the growth in projected caseload cost per hour and hours per case. I think it's important to also note that there are no budget solutions related to IHSS program in this cycle.

Thank you. And I'm going to take question two, Claire Ramsey from CDSS. Question two related to LAO notes that IHSS service utilization continued to be lower than historical levels and if the Department had any understanders of the driving of that decrease.

I just first want to acknowledge that the LAO in their report did a good job highlighting several of the possible reasons behind this lower paid case rate that we're seeing coming out of the pandemic.

It is something that we don't have an ability to have a perfect read on what is causing the decrease. We do think that it may in part be due to delays in providers being associated with cases. So it's not actually that someone isn't getting a provider and being connected to a provider, but instead that there may be a lag between those two things happening, which on paper looks like a case does not have a provider.

We are looking though more closely at that data and we do think now that we are seeing increases, as Ms. Filosena referenced in the number of cases because we are expanded to a larger population with the undocumented expansion, that we may just be seeing a new caseload coming on: getting familiar with the IHSS program, getting familiar with their providers being associated with cases. And we're also working to remove those barriers to delays, working both with the counties. This is largely a paper process to connect cases.

So trying to see if we can streamline or make that simpler for everyone. And we're also trying to work with providers so they have the functionality to put their own provider on their case. And then this is something we will continue to monitor because we do want people to use the services they're authorized for. That's very important and we don't want there to be any unneeded barriers to that.

I will now go on to question three, which was reference to the elimination of the Medi-Cal asset limits that's going to increase the number of seniors and people with disabilities eligible for IHSS. The question relates to the budget estimate of approximately $48 million in General Fund. The question about how that estimate was derived and how we project caseloads and expenditures associated with the removal of the Medi-Cal asset limit.

The 48 million in General Fund cost in FY 24-25 was calculated by multiplying the projected new IHSS monthly caseload by the average monthly cost per case and then by the number of impacted months. This is the methodology we use to project IHSS services and IHSS administration respective to the individual cost per case. The total amount is calculated by the sum of these results. The new IHSS caseload referenced above was actually derived using projected caseloads from the Department of Healthcare Services based on what they project the new number of recipients will be because of the asset elimination.

And then we use an intake ratio to determine how many of those Medi-Cal beneficiaries will be eligible for IHSS. I do want to flag that CDSS does not actually have access to data elements that show whether someone received Medi-Cal because they were no longer blocked out because of the asset limit. That financial data is something that DHCS has.

They have that data, but we can only see very limited Medi-Cal data, and so we're relying on them for the initial number that we use to apply our intake ratio to, and then I will turn it over to Deputy Director Filosena for question four.

Sure. Thank you so much, Ms. Ramsey. I'll be providing the updates on the various initiatives, including the eligibility for minor recipients, the stakeholder process to explore regional and statewide collective bargaining for IHSS providers, the implementation EVV, and also give some updates on the backup provider system. So for minor recipients, we did issue an ACL on December 21, 2023. There was a 60 day implementation time frame which ended at the end of February.

Our understanding, and we've been working with the counties as well as our stakeholder partners, that the impact of cases are being reassessed at the time of reassessment and or at the request of a stakeholder, like a legal advocate, or even at the request of a parent. And so we're seeing that that is happening. There have been no concerns raised to us from any advocate in our community as of now, and so we'll continue to monitor this. We'll probably know more as the year goes on.

As we see these minor kids cases who didn't have a provider before, we'll probably have a provider now where the parent was not able to be a provider because of the rules, and now because of the streamlining, they're able to be a provider now. So we'll be monitoring this throughout the year. For statewide collective bargaining, we have made a lot of headway in this. We actually had our first level setting meeting on February 22 with the group.

So we formed the group, all of the members of the group, before the actual work group kicks off the formal meetings, we're doing three level setting meetings with the team. So that way to provide like a basic overview of IHSS, to do an overview of the program funding and the MOE, the county MOE, which is really complicated, and then a level setting meeting about the current bargaining and how that works now.

The workgroup is expected to formally convene in April and we plan at least having monthly meetings through August, dividing the meetings by topic so that we can hit all of the requirements in the legislation for the report. We are in the process of contracting with two consultants at this point. One is High Road Alliance. So we are bringing them on to be a facilitator for the work groups.

So they will help us do a lot of the facilitation, a lot of the conversations, be asking the questions. And then we're also bringing on UC Berkeley Labor Center for our researcher. So we are in the process of all of that. Everything is moving forward and I don't see we are not experiencing any delays as of right now. For EVV, we began the certification process with CMS in January of 2024. We have asked all the questions, submitted all of our documentation.

Currently, 57% of nonliving providers are utilizing EVV. We have some work to do in compliance. So what we continue to focus on is really increasing that compliance rate by sending letters, emails, social media posts, banners on the electronic services portal. And also we continue to hold training webinars and provide training materials to people, just in case accessing the system is a barrier and we are providing those materials in the threshold languages right now. And then for the backup provider system.

So we have been up for a year, a little over a year. We reviewed the utilization of the system and it was lower than expected. So what we have done is we sent a survey to the counties and public authorities to identify potential challenges with the current backup system and its administration, including barriers for access.

We just closed the survey on February 29, and with 31 counties actually providing us responses, which was a pretty good response rate, some of the preliminary takeaways were that there were difficulties with finding enough providers to provide backup services due to existing provider availability distance. Sometimes there were language barriers, and occasionally there were recipient refusals as well.

So as part of that survey, there was also a request to us from the counties and public authorities to provide some materials to be provided at provider orientations to do like recruitment, like, hey, this is something that you can do. You can be a backup provider and also to provide to eligible recipients at reassessment so that they are made aware that they can access these systems and how to do that. So we will continue to work with the counties and public authorities on this.

We really are committed to making the system work for folks. We know it's important and we really want to remove those barriers as we move forward and also really try to give a lot of support for the recruitment of providers as well. And then I'm also going to respond to question number five, which is with regards to the impacts of the resumption of Medi-Cal redeterminations on the HSS population. So this was something we have done a lot of focus on over the last year.

We continue to monitor all the progress data. We're looking at it constantly. And to promote, we're really promoting information to recipients by doing outreach. We're leveraging the materials that our partners at DHCS created in all the different languages. We're doing social media posts. We're also pushing those messages to our recipients.

And we're also providing a monthly file to counties of the people who are due for the following month so that they can do outreach to those individuals and work with people who may be having difficulties with their redeterminations. We are seeing the average number of folks who are losing their IHSS due to no Medi-Cal is significantly lower than it was pre-pandemic.

So on average, it's about a little over 200 people losing their Medi-Cal when before it was closer to 1,300 people per month for this reason. So all of those efforts, I think, are really paying off, as well as the efforts that our partners at DHCS are doing as well in this area that are making things easier for counties to process and making it easier for people to respond to the and fill out their packet and get them submitted. So we're really seeing some great strides here. And I did also want to mention that we'll be providing a more in depth briefing on this topic on March 14 for the Legislature. So that is planned next week.

Thank you so much. Department of Finance, any additional comments you'd like to add?

Marlies Perez, Department of Finance, no further comments.

Thank you. LAO.

Yes, Juwan Trotter with the Legislative Analyst Office. So while there are no new major proposals for in home support services. There are a couple of things that we are continuing to monitor and expect to have updates for at the mayor vision. Firstly, we are always monitoring caseloads and checking the administration's estimates to most recent actual caseload data. One thing we are continuing to track, as was mentioned before is since COVID, this decline in the percentage of authorized cases that are submitting timesheets and receiving paid services.

So as the agenda noted, prior to Covid-19 about 91% of authorized cases were receiving services, whereas post Covid that number dropped to about 88%. In addition to some of the reasons that were mentioned, we also believe that one reason could be that both recipients and providers may be more hesitant to interact with folks outside of their household due to public health concerns as of COVID But regardless of the reasons and despite some monthly fluctuations, this trend has continued to hold.

And so this is something we do want to continue to monitor and get back to you before the May revision. Secondly, we are continuing to monitor these expansions to Medi-Cal and their implications for who is eligible for in-home support services.

As known in the agenda, some of these expansions include the repeal of the Medi-Cal asset limit, the continued expansion of full scope Medi-Cal to undocumented individuals regardless of immigration status, and as well as the resumption of the Medi-Cal redetermination process that was temporarily paused due to Covid. Lastly, we're also continuing to monitor the implementation and utilization of these newer IHSS proposals. So the permanent backup provider system, as well as the elimination of the minor recipient provider eligibility requirements.

And so, given the significant budget problems, we are looking at these new initiatives and these caseloads under the lens of trying to determine whether actual costs are coming in line with budgeted expenditures and if these budgeted expenditures or if these actual costs are coming in below budget expenditures. We believe that through kind of right sizing the budget, there could be savings to be had in the budget. And so we will continue to monitor this data as it comes in and expect to provide further updates at the May revision. Thank you.

Thank you so much. I know there's no budget solutions here, but I think there could potentially be some savings and even budget solutions for the current year and the next fiscal year. I'm really interested in the permanent backup provider system, the paid sick leave utilization, and the streamlining eligibility for minor recipients, finding savings in those three categories, as we know, especially with the eligibility for minor recipients. That program started six months past the time that we anticipated, so that's current year savings.

And then looking at future allocation to these previous two programs, permanent backup and paid sick leave, and how much we really need to allocate moving forward. There's not going to be a lot of opportunities we're going to see in sub three where we're going to find some extra funding like this and how we can utilize that to make whole other programs would be really ideal for us. Colleagues, anything else? Senator Roth? So you were right, weren't you? Weren't going to speak today? Yeah, that's my only comment on those items there. Moving on to issue number five, In-Home Supportive Services Career Pathways Program.

Hello again. Claire Ramsey for the Department of Social Services. I'm going to provide, as requested, an overview and update of the IHSS Career Pathways Program. As I think all of you are familiar, the IHSS Career Pathways Program was a new training program created for in-home supportive services and waiver of personal care service providers that was meant to increase the quality of care, assist with recruiting and retaining providers, and providing opportunities for career advancements to IHSS providers through these training classes.

The providers can complete classes in five career pathways, two general pathways, the General Health and Safety Pathway and the Adult Education Pathway, and then three specialized pathways, one on cognitive impairments and behavioral health, one on complex physical care needs and one on transitioning to in-home care and community based living. To implement this career pathways program, we completed two procurements to bring on training vendors.

We also brought on a separate vendor to create career lattices to help providers understand what their career options were both in the IHSS program and outside of it in other healthcare fields. And we are providing coaching services to assist providers who may be interested in exploring some of those additional healthcare opportunities. A small set of classes launched in October of 2022. Those classes were offered by several of our county public authorities, but the classes themselves were made available statewide.

In January of 2023, our two training vendors, which are Homebridge and the Center for Caregiver Advancement, both came on board and started offering a much broader array of classes and many more actual class instances of the classes, and we were able to add additional classes in March of 2023. Then we also most recently worked with our training vendors to double the number of classes starting in January of 2024. Our statistics so far as of January 31, 2024 we have had 13,340 providers complete at least one training class.

But our data is showing that providers are taking far more than one class and many are completing enough classes to earn the incentive payments which we are starting to receive claims for. We have worked continuously with our training vendors to make more classes available, and we appreciate both vendors for being open to continuing to increase the number of classes.

As I mentioned, we have doubled the number of classes in January and we are trying to determine kind of what impact that will have on availability and access to classes for providers. We are seeing good results from that. We looked at our data basically from January and through the first half of February, and we see that we have received 40,000 claims for training time in those six weeks. And we have also received 2,000 incentive payment claims that we are working to process.

We do all those processes manually. And then we have continued monthly outreach to providers through our electronic services portal, through social media, and through email to make them aware of new class availability and to encourage them to enroll in classes. And the agenda did a good job going over all of this. But I'll just flag that for the incentive payments. For incentive one, which is completing 15 hours of training in one of the pathways, we have now processed over 14,600 claims.

For incentive two, which is those 15 hours plus working for somebody for one month, we have processed 1,177 claims, and the third incentive, which is like the second, only working for somebody for six months instead of one month. We have processed 292 claims, but we expect those numbers to keep increasing as those six months. It's more likely that someone will have taken the classes and gotten six months of time in 2024.

And the last thing I'll just flag is that we've processed over since the end of January, more than 280,000 claims total. I'll move on to question two, which is how has the extension of the HCBS spending plan that was approved as part of the 23 budget affected the career pathways program? I'll just say it has been a really important extension to help us to continue the program.

This program was only stood up under those dollars, so it allowed us to continue it into 2024 when originally we would thought we would have to conclude at the end of '23. Again, as I mentioned just from the first six weeks of data, we are seeing a really high number of claims being submitted and we expect those trends to continue with the increased number of classes. On the current schedule, the classes are scheduled to end on September 30 of 2024.

Providers will be allowed to continue to count the month of October toward those incentive payments, particularly the one month and six month incentive payments. And then we are requesting providers to submit all claims by November 15 so that we can pay them all out by the end of the year and close out our accounting as required under the HCBS spending plan. Then I'll go to question three, the latest data available was showing only $40 million of the 295,000,000 had been spent.

And so what was the administration's plan to ensure this funding was fully spent? So I would just like to point out that that 40 million is timed off of the end of September, so the end of only three quarters of last year. So we are working to provide updated numbers.

We will both be able to provide updated expenditure data sooner, and then we'll be able, we believe, by May revision to have enough data from all the increased classes to determine whether there will be any remaining funds by the end of the year. And we are continuing to monitor our class attendance, training, and incentive claims so that we have ability to update our projections based on actuals. And I got ahead of myself a little.

Just say that those updated numbers, we think we can basically provide you with data through at least the end of last year, probably by the end of this month. So we'll have some updated expenditure data then. And we really, again, want to encourage, and we keep doing our outreach and making sure that providers know about the classes, that they have access to the classes, trying to eliminate people getting waiting lists or seeing classes as closed. And we really want everyone to take full advantage of this opportunity while we continue to run it through this year. And with that, I will pause. Thank you.

Thank you so much. Moving over to Marlies, Department of Finance.

Marlies Perez, Department of Finance. Nothing further to add.

Thank you. Juwan.

Juwan Trotter, the Analyst Office. So, as we noted last year, this program has been slow to start. And though, as was alluded, the spending has begun to pick up over the last couple of months, we still do have some questions on if it is possible to expand all of the lauded funds by the close of the program.

And so, as is noted in the agenda, the Joint Legislative Budget Committee has been working with the administration on this topic and gathering more information on some spending, the spending trends and proposed timelines for spending in the next couple of months.

However, we do, and I guess with that, we do believe that the earlier we can get that information back, as was noted, and get some of those answers, the better off the Legislature will be in kind of developing a plan for how to best expend those funds in a way that best aligns with the Legislature's priorities. Thank you.

Thank you. Before we go move into questions, Tiffany Whiten is going to be joining us, is joining us from SEIU.

Tiffany Whiten with SEIU California on behalf of our 700,000 workers across the state, but in particular over 400,000 long term care workers, the majority of which are IHSS providers. The home care workforce, including the IHSS workforce, consists disproportionately of women of color and immigrant workers who have historically been excluded from basic worker protections and been subject to poor job quality. It is a workforce that has been too long unseen and underappreciated.

This underscores the importance of the IHSS Career Pathways Program, a paid and incentive training program for IHSS and WPCS providers helping to advance racial, gender, and linguistic equity by reframing and repositioning the workforce as one to be invested in, valued, and treated with dignity.

The program aims to provide high quality, accessible training to IHSS and WPCS providers statewide, to stabilize the workforce and encourage the recruitment and retention of providers, to improve the quality of care for consumers, and to provide opportunities for career advancement in home and healthcare.

The CPP aligns with California's master plan on aging's 23-24 initiatives to diversify the pipeline of direct care workers by testing and scaling emerging models to explore opportunities to expand career pathways for direct care workers and to develop an inventory of evidence-based training, career ladder, and certificate certification programs that are accessible, person-centered, and culturally and linguistically responsive. The IHSS Career pathways Program, or CPP, responds specifically to the industry's lack of opportunities for training and career advancement for IHSS providers.

No former career ladder exists within IHSS and providers seeking career advancement have to look outside of the IHSS program or other professions and industries. As the program continues to expand to care for more populations in need, we must work to stabilize and uplift the workforce by formalizing training opportunities and building out career pathways within IHSS, which is exactly what CPP has been working towards. The benefits of training are far reaching.

As providers are empowered with knowledge and foundational and specialized skills through CPP, consumers can benefit immensely from an improved care experience. The CPP provides a remarkable and historic amount of funding for training the home care workforce, which in return will enhance the delivery system and provide improved care for the consumers of the program. We implore the state to do everything it can to utilize every dollar allocated to the program and make good on the intent of the program as we can do so by having an 18 month extension to use all the funds.

I sat before you all last year in March on the same issue and only 2.7 million of the 295,000,000 was spent. We were told the dollars would definitely be utilized in the initial time frame by March 2024. The program was not on track to utilize the funding in that time frame, so we requested an extension, which is the current December 2024 deadline.

But with only 41 million being spent to date, it seems like we are again not on track to realize the total funding and thus the true intent of the program. Given there are claims not accounted for and more to come, it still doesn't seem like the money will get out the door by the end of the year.

While we appreciate all that goes into making the program work, signing contracts with vendors, increasing the amount of classes that are hard to get in, I might add, and processing of claims, stopping the program prematurely because we couldn't get all the funding out the door in a given time seems contradictory to the goals of the master plan on aging and the intent of the program.

We would like to continue to work in partnership with this wonderful Committee, DOF, DSS, and DHCS, to ensure that providers are given the opportunity to sharpen their craft, increase their knowledge, and ultimately better serve their consumers. We are committed to exploring the barriers of the program and how we can mitigate them.

We truly believe that CPP is a valuable resource that should be a formal tool embedded in the IHSS program, not only for this short period of time, but ongoing, as it is imperative that we get it right. We have the infrastructure in place and providers that are more than willing to engage. All we need to do is get the money out the door to keep the program going so that all can reap the benefits of such a great program. Thank you for the opportunity to speak in front of you today.

Thank you so much, Tiffany. Last year during this hearing, we had utilized about $2.7 million of the funding. We have jumped up to 41. I do recognize those are numbers until September, but that trend is about $3 million a month. I do the math, and we would have to do $31 million a month to hit all that number. I'm still very concerned that we're not going to hit it, and I know we can't do an extension in this situation like we were last year.

This is a federal deadline and I hear you, but we can't. So I'm dealing with this reality of, of course, let's utilize it as much as possible for career pathways. But as I heard from LAO, the JLBC is talking to the Administration on how else we can use this fund because I don't want to leave a dollar or table when we're proposing DDS rate reform pushback. So that's the first thing that came to mind.

Director, I know you're not here, but it's the first thing that came to mind. Can we use, I know we've done this in the past where we come to the Administration where we've allocated a shift in funds under HCBS. And I'm wondering, I don't want to wait till the May revise. I don't know what those conversations look like. Can we use some of that to do only a six month delay for DDS rate reforms? Because we could utilize six months funding under HCBS. It's complex.

I understand that, but the conversation we need to start now and now in May. Now shifting back to the priority at hand is eight, age career pathways. I know that's the number one priority, and I appreciate that the classes have been doubling. My sister takes a class. She's so excited. She tells me about the classes she's taking and stipends, and she continues to take classes because she's an IHSS healthcare provider. And I know we're still having some barriers for individuals.

What are we doing now differently? We were able to ramp up. We're starting what now are we doing to be speedy Gonzalez as much as possible to get even more classes going, removing the last barriers that we have potentially on getting these people in these classes to hit? Because I don't think we're going to make it. I really don't think we're going to make it. But what do you envision is needed to make it?

Appreciate that question and appreciate just flagging that that larger question about shift in funding, right, is such a larger question around the HCBS funding that CDSS is not the lead there, but we'll take that back, ask the administration to discuss that. I really think we have unlocked what we needed to unlock in terms of doubling the classes. We did see that we did not limit the number of classes people could take in the program.

And one of the things that was challenging about that is that people who were maybe early adopters and were in and were able to kind of know the system, understand the system and get into classes quickly, which is both great. We want people to take the classes, but it meant that people maybe who were finding out about it newly or weren't familiar with the system by the time they got there. When a new tranche of classes opened up, a lot of classes were already closed.

So that was, I think, the biggest barrier we were seeing to really expanding the number of people who could access the classes, and that's why we did double the classes in January. To your question about the rate of spending. We also anticipate that really, it's not going to be linear because the incentive claims are really where the big dollar amounts are going to start coming.

So one of the things we were kind of looking at was while we're paying out wages, that's 1 hour at a time is a small amount from that huge $295,000,000 allocation. But as we start paying out incentives of double 500 and 2,000, we'll start to see the money really ramp up at a much higher rate.

So that's why we're trying to look at our actuals to see to your point, if we sort of started slow and now are really at inflection point and curving up, and we are committed to spending all the dollars within our program. As Ms. Whiten said, this is a really important program. We want to support our IHSS providers. We don't have a program without them. The program only works when we have both sides. And so we completely understand what you're asking about shifting of funds.

And I would just say as a department, we're really committed to this program and to spending the funds and to making sure that all of our IHSS providers have the benefit of these classes and of the incentive and training dollars.

On the same page as you. At what point do we sound the alarm? Do we have an internal month? Are we waiting to the May revise to potentially sound alarm if we're halfway through the month? Is there something an internal mark we're looking for where we're going to be really worried?

We think that the May revision will be the right moment to determine whether or not the full expenditure can happen by the end of the year and whether there'll be any remaining funds. If the Chair would like to ask for a different date, we're open to revisiting sooner, but that's what we think will realistically have a good sense.

Okay, I'm just wondering. The May revise comes out and it's blink of an eye, right. There's going to be half a breath left to maybe potentially shift if we can do that. I feel that it's a little too late for this. I would like to get something sooner in whatever we have, whether it's just super raw, not fully cooked, but just something to be prepared for the May revise.

Thank you. We will get you additional information sooner. We'll work with Elizabeth to figure out.

Thank you. Senators? Senator Roth.

Was this the program that we spent a lot of time on last year?

Yes, it was. Yes, it is.

You know, I remember back during my days in the military, and I'm not sure that those that were in charge of planning plan very well, but you never quite knew whether you were going to have a budget surplus. And they'd ask the agencies and the work sections to submit requests, procurement requests for mostly equipment, not programs, and they'd stack them up, and then if they decided if we didn't spend all the money, they'd just go through the stack from top to bottom.

And whether you needed a new computer or not, or you needed a new desk chair or not, you'd get a new computer, you'd get a new desk chair, and they'd line them up in the hallways. Sort of a wasteful way to deal with government spending and taxpayer money.

You're asking us to be like Oprah, right? You get us.

And I guess my questions last year, I really can't remember them, but I suspect what they were, were tied to trying to plan this out. And I realized that there are variables in what you do.

But I'm hoping, starting today, we can figure out a plan, and I'm not the chair of anything having to do with budget, and so I wouldn't be the one to be contacted, but I'm hoping there's constant communication with the budget staff on where we are on this expenditure plan, and that there has been since the last time we came to the party here to have the conversation, because it would be unfortunate if we either spent money on stuff that really isn't critical to the mission, because this is a very critical program in our state, and it would also be equally unfortunate if we didn't use the money that we're provided.

So those are just my comments, Madam Chair, for what they're worth. I'm hoping we have very talented people here in the administration and particularly working this issue. And I know you can figure this thing out. So looking forward to a successful outcome and spending the program down to zero.

Your thoughts are worth a lot, Senator Roth, and I'm just going to ask out of the blue question, do we have the ability to increase the amount of the stipends that go out?

Thank you for that question. And Senator Roth, thank you for your comments. We can take that back and look at it. The amounts were not set in statute. We were determining them based on what we thought would allow a large number of people to come in and us not to run out of money. And just as Senator Roth's point, we have done a lot of planning, but it was a very large program to set up under a very tight timeline. So we can certainly take that question back and provide the Chair with additional information on that question.

Thank you so much. Any other questions? Okay, great. We're going to move on to issue number six, our final issue under this section: APS planning and development of a data warehouse.

Good afternoon, Madam Chair, Committee Members. My name is James Treggiari. I'm the Program Administrator of Adult Protective Services and I'm here to talk about the budget change proposal regarding the APS data warehouse. I think the agenda did a really good job of giving an overview of this proposal, and I will just cover some of the highlights. California was allocated approximately $1.4 million by the Federal Administration for Community Living in the Elder Justice Act to support the state's APS program.

The submitted proposal is asking for the authority to spend the federal dollars on two positions within CDSS to support and build the data warehouse to be housed at CDSS for the purpose of gathering and reporting on case level data from county APS programs, as requested by ACL's National Adult Maltreatment Reporting System, commonly known as NAMRS. It's anticipated that the database will be launched in January of 2026.

Our plan is to work with the counties and CWDA to develop requirements and define business processes with the shared goal of reducing county workload associated with the data reporting, as well as building a database and interface that will connect existing county case management systems, automate data transfers, and collect case level data directly from county databases, making federal reporting and trend analysis more accurate.

It's anticipated that this solution will bring CDSS into compliance with the NAMRS data and reporting requirements and lead to consistent statewide data reporting by all counties. Having case level, timely data will inform and impact outreach, APS worker training, and make sure that APS programs response to abuse allegations are more timely, effective and equitable for program clients.

With aggregate data, there is no way to analyze the intersectional features of these cases to see if there are targeted interventions that can be deployed to address the needs of these clients. KSC level data will allow the program to better identify and resolve disparities within the community while improving equitable outcomes in California for older, independent adults, especially those from disenfranchised communities. It will allow the CDSS to report accurate and complete data to NAMRS to help inform and prevent intervention practices on the national level of the adult maltreatment field.

The resources will aid California in its ability to examine the trends and patterns of abuse statewide for the first time in APS's programs in the APS program's history. Thank you.

Department of Finance, any further comments?

Marlies Perez, Department of Finance, nothing further to add.

LAO?

Juwan Trotter, Legislative Analyst Office. We have no concerns arise at this point.

Are you new to LAO?

I am, yes.

Welcome.

Thank you.

This is on the floor. We would call a support support. So we have no questions on this item. We're going to hold it open and move on. I was just kidding. I have one more issue under this section. Issue seven, a community care licensing overview.

Claire Ramsey with CDSS and my colleague Kevin Gaines is coming up as well.

Good afternoon. Kevin Gaines, Social Services Community Care Licensing, just addressing the three questions on the agenda. First, the overview of the 24-25 budget for community care licensing. The agenda does a great job of spelling out the 270,000,000 itemizing those revenues that support CCLD, including our federal funds, state funds, the special funds mix that comprise that amount. These dollars are expended on 1,571 staff in 16 unique locations throughout California.

Staff that are conducting approximately 34,000 inspections, 15,000 case management visits, investigation and disposition on 17,000 complaints, the process of 250,000 background checks, 7,000 applications for new licensures, and procurement on two major IT projects. A number of things going on in fiscal year 22-23 we proposed no new spending or no new proposals for 24-25. The question of guardian backlog planning activities for a replacement to the guardian system that processes background checks and controls that workload.

As of January of 2024, there were 3,013 cases that we would put in that backlog, which is considered 120 days past, 120 days old or older. We've continued to make progress. We've done a lot over the last year to get that number down, and we've seen some really good outcomes over the past year attributed to three different factors. One is the additional staffing that was granted in the 23 Budget Act.

Second was AB 1720, which was implemented at the beginning of 2023, which significantly increased the number of standard exemptions that could be processed as simplified exemptions, and just generally increased knowledge and sophistication in the navigation of this Guardian system, both on the part of staff and on the part of stakeholders. There's a huge do it yourself set of functions within Guardian, and so we've been working really hard to provide technical assistance and train our licensees and other stakeholders.

As far as Guardian replacement, we're in stage two of the four-stage project approval lifecycle and we're nearing completion of the discovery and research that will help us perform some market research and provide some alternate solutions as a Guardian replacement by the end of this calendar year. We've contracted with the Guardian vendor and we've completed a number of enhancements that include updates and notifications that were not previously part of the Guardian feature package, some canned reports and additional navigation enhancements that help improve the user experience.

Unless there are questions, I'll go on to the third question. All right. Regarding the Home Care Fund and actions that we've taken to oversee and stabilize the Home Care Services Program. As you know, the 23 Budget Act provided us the additional resources that would help us expand our capabilities and expand from a bureau to branch level. We got 15 positions in that budget. Nine of those positions so far have been hired. Six are still under recruitment.

The addition of those staff is providing us the ability to investigate businesses that are providing unlicensed care throughout California and to issue civil penalties which will hopefully help us generate additional revenue to stabilize the program. We're continuing to meet with community partners and build lines of communication so that we're seeing and accepting opportunities for the improvements that would help to populate the regulation and internal policy packages that we have under formation. And we're finalizing approval for the first quarterly report that's due to you. As a matter of fact, I believe we submitted that already. So unless there are questions, those conclude my remarks.

Thank you to I was mostly interested in the guardianship, the Guardian system. Guardian system. Because we talked about this a lot last year. We spent a lot of time on that and I'm glad to see that we're trending the right way. Do we continue to trend the right way? And I don't know if I'm looking for an average, but I know the numbers are from compared to July 2022.

Do we have anything that we're comparing to just last year and how much greater that is and is a 70% decrease more from what we before? I've lost completely what I said. Is the trend that we're seeing now, do we attribute it more to prior to what we did last year or do we jump up to 70% decrease because of what we did last year?

We think that the addition of the staff, we had 12 positions that we were able to hire into to process exemptions, to handle phone calls, handle emails and help with self service. I think a good portion of that was the huge amount of calls that were able to, applications, that were able to move into the simplified exemption process through AB 1720. That helped us. Since the enactment of 1720, we've completed over 20,000 simplified exemptions.

Do you have an internal goal to hit that we're like, oh, we're comfortable with having maybe 10, 20, over 120 days, that's something we can get rid of?

I believe we can. I think given our current staffing, even with the 12 additional that we hired over the last year, that may be a multi-year process. But again, as we navigate the software more effectively, as our stakeholders and public users of the system become more savvy, we believe that backlog will reduce on its own through natural means.

You're thinking a couple?

While we're continuing planning and procurement activities on the replacement system that hopefully will be easier to navigate for everyone.

Okay, nothing further on this end. Thank you so much.

Thank you.

That concludes the presentations from the Department. We have one issue for proposal of investments. The County Welfare Department will be presenting under three minutes on their emergency services and disaster response funding.

Good afternoon, Senators. Thank you. My name is Eileen Cubanski. I'm the Interim Executive Director of the County Welfare Directors Association. Thank you for the opportunity to speak to this issue today, and I'd also like to thank Senator Dodd for championing this request on our behalf and to his staff for their support on this issue. CWDA is requesting 14 million General Fund annually to provide dedicated funding and resources to bolster county human services departments, emergency services and disaster preparedness and response.

Over the past seven years, the state has experienced an unprecedented number of emergencies and disasters, catastrophic wildfires, intensive storms with severe flooding and winds, Covid-19. California will be recovering from these complex disasters for at least the next decade while continuing to respond to and recover from future disasters. Counties and county human services agencies in particular, are at the front lines of these response efforts.

The California State Emergency Plan places the California Department of Social Services as the lead state entity for mass care and shelter disaster response. The state structure, however, adopts a local first emergency management system, putting local government emergency plans at the forefront of emergency response. Therefore, when disasters occur, county human services agencies have responsibility under emergency response plans for the mass care and shelter of their county residents.

County Human Services Agencies' staff are diverted from their regular duties to coordinate human and material resources to establish mass care and shelter services. They conduct notifications and outreach of disaster services. They assist program recipients with disaster assistance applications. They handle transportation of program clients. They provide services to persons in need of targeted and or special services.

Additionally, most county human services departments are tasked with the lead department for post disaster response, recovery and services, with one third of them reporting that they provide these post disaster recovery services for more than 12 months after an event. And this is just our formal disaster work. Increasingly, the state is asking county human services agencies to provide sheltering services to the unhoused population during extreme weather events and other emergencies. And all of this is done on top of county staff's regular duties.

And since there is no dedicated staff, it's covered on an ad hoc basis within county structures. The vast majority of this work goes unreimbursed by federal disaster funds, and so county human services agencies are left to fund these activities with their own department funds outside of all the state allocations that were provided. So we're not requesting funding to cover all these costs of all the redirected staff and the resources that we use for mass care and sheltering.

Rather, we're seeking resources for just one dedicated staff person per County Human Services Agency to provide that continuity of staff whose purpose it is to help them better plan and coordinate local resources prior to disaster striking, so that during both the disaster and the recovery, we have a more efficient and effective response.

You can wrap up.

I acknowledge it's a bad budget year, and I don't envy your decisions. Unfortunately, disasters don't care about the budget, and we will always respond as we need to during disasters. So I thank you for your consideration of this request. It is very important to our members to provide these critical services. Appreciate it.

Thank you. Department of Finance, any additional comments?

Department of Finance, this proposal is not part of the Governor's Budget, so we have no additional comments at this time. Thank you.

LAO?

Good afternoon, Chair and Members. Angela Short with the LAO. No comments on this proposal.

Okay. No questions from us. Thank you so much for your presentation. I want to note there are three items that are your agenda. Lift SSI SSP grants and Revive the Special Circumstances Program, IHSS participation cap update, and IHSS County Administrative Bridge Funding. They're on the agenda, but not eligible for presentation. And I do want to do kind of like a public service announcement. We have to be very mindful of new investments you're seeing up here. We're trying to fight just to keep previous investments into the budget.

So moving forward, we are going to be reevaluating how we're going to be looking at proposal investments for all the stakeholder proposals. Just to again, be mindful of our budget situation. Okay, now we're going to do public comment on issues two through eight. If everyone standing is going to do a public comment, we're going to lower the threshold to 45 seconds.

Okay.

If you can do 30 to 45, would be really great.

Great. I'm Rebecca Gonzalez with the Western Center on Law and Poverty. But I'm here today on behalf of the Californians for SSI Coalition, which is a coalition of over 200 groups. I'm going to go straight to what we're asking for. We ask the Legislature, and we know it's hard budget times, but it is necessary to lift grants to 100% of the poverty level over three years.

We know the deep cuts that have been made to this program in the past, and now the grant is only at 94% of the federal poverty level. SSI recipients still struggle to make ends meet. They rely on food banks. Medi-Cal does not cover all their expenses. Rents are rising. In Los Angeles, the fair market rent for a studio apartment is about one and a half times the SSI grant. So we do urge the Legislature to look at the revenue side of the budget in order to make some investments possible. Thank you.

Thank you. And I apologize. We're going to cut it at 30 seconds. We still have a lot of things to go over today, so we're going to 30 seconds. And if you just want to do me toos, just do me toos if someone in front of you has said the same thing. Thank you. Go ahead.

Eileen Cubanski, again with the County Welfare Directors Association, wanted to put a plug in for the other proposal for investment that we have for IHSS Administration. $51 million in one time funds to bridge till we get a new methodology. We also have a trailer bill request for that. And I did just want to also say that with respect to the housing conversations, we are working very closely with the department and our county members.

I did want to just reiterate that we are trying to figure out how we can make that proposal work and at what level. So I just wanted to weigh in on that as well. Thank you.

Thank you. Perfect timing.

My name is Judy Jackson and I am a 78 year old recipient of all these programs. And I want you to know that the Alameda County Social Services Coalition says that SSI is still $34 below the poverty level for the average recipient and that it is $375 below the fair market rate for a studio. So we need the increases that were promised, and we thank you for the ones we've gotten.

Thank you so much.

Hi, Trinh Phan with Justice in Aging is supporting lifting SSI grants and reviving the special circumstances program. The recent grant increases are now bringing the grants back from recession lows in order to hold on to the real value of these increases. Any COLA increase this year would help. SSI grants are used for basic needs. The coalition spoke with SSI recipients in Los Angeles last week and asked what they would use a grant increase for. 250 people responded, 40% said rent. About a third said food, medical expenses 13%, and 15% other. Thank you.

Hi, Chair and Members, Gabby Davidson with the California Association of Food Banks here to uplift a budget request from the Californians for SSI Coalition. Firstly, just want to thank the Legislator for the SSP grant that took place in January and that there's no cuts proposed to SSP grants this year.

To support our most vulnerable, we also want to ensure that there are no cuts to other safety net programs and when investments allow, we want to support our older adults and people with disabilities by reviving the special circumstances program. Thank you.

Thank you.

Kim Rothschild, California Association of Public Authorities for IHSS in support of the public authority funding and the backup provider admin funding, as it could take six to 8 hours for public authority staff just to work on one backup provider case. Also in support of CWDA's request for 51 million in bridge funding. Thank you so much.

Thank you.

Hi, Brenna Lamuska. I'm with Home Match, a nonprofit home sharing program. We specifically are concerned with aging in place and homelessness prevention. I just want to say that home safe is a vital need and that I ask the Committee to make a commitment to protect the funding of housing advocacy. Thank you.

Thank you.

Good morning, Madam Chair, Senators and the Committee. My name is Gavi Lopez Loomis. I'm an IHSS provider for my son in Nevada County. LESTAT respectfully requests your support for issues number five and the IHSS career pathways for the program and the IHSS state participation cap under issue eight. Thank you so much.

Kelly Brooks on behalf of the Urban Counties of California, the Boards of Supervisors of Riverside and Ventura counties in support of CWDA's IHSS admin proposal. Just want to note we have urban counties with social workers carrying caseloads of three to 500 IHSS cases, which means our reassessments are going slow and people may not be getting the full amount of services that they're entitled to. So just want to put a pin in this. We totally understand the budget situation, but I think the proposal includes trailer bill language that will put us on a path to getting toward better caseloads. Thanks.

Thank you.

Hi, Danielle Bradley on behalf of the California State Association of Counties, CSAC joins CWDA as a co-sponsor of the budget quest for 51 million in one time for IHSS Administration. Aligning our comments with CWDA and UCC, CSAC also strongly supports the human services disaster proposal. Human services agencies play a critical role before, during, and after, and this funding is crucial to uplifting that work. And finally, CSAC shares concerns of the funding delays proposed for Home Safe in HDAP. Thank you.

Thank you.

Good afternoon, Madam Chair, Members. Martha Guerrero, representing the Los Angeles County Board of Supervisors, also in support of the IHSS Bridge County Administration Funding Proposal. Line our comments with urban County Caucus, CWDA and CSAC. Thank you.

Thank you.

Good afternoon. My name is Brenda Garner. I'm a home care provider, and I want to come and talk today about the Career Pathway. It is essential that home care providers such as myself learn more as possible that we can learn--so we can be able to help our fellow recipients in California. Thank you.

Thank you so much, Brenda.

Good afternoon. I'm Daphne Danston. I am an IHSS provider. I just want to tell you that I experienced a hard time going to the Career Pathways Program. Would you please make it easier for us because for me, I'm taking care of my two special need boys and it's not easy for me to navigate for the Career Program, and I request for extension of this. We have almost half a million care providers that's accessing the Career Pathways. Thank you.

Thank you so much.

Good afternoon to all. My name is Constance Hill. I am also an IHSS provider. I am also in support of the Career Path Program. It's very imperative that an extension will be kindly given. It is necessary. I'm trying to get my feet completely in it and emerge 100 percent so I can be a better provider, caregiver, and to take care of my clients as well. Thank you so much for your time.

Thank you.

Good afternoon. My name is Belinda Wells, and I'm a care provider in El Dorado County, and I support the Career Pathways. I haven't had an opportunity to do it yet and so I'm planning on doing it. So if you can honor that extension, that would be awesome. Thank you.

Thank you.

Good afternoon. My name is Hannah D, and I IHSS provider from Placer County. I'm caring for my both parents who are like mostly disabled. So the Career Pathway Program has really helped me to take care of them, especially for my dad because he had cancer and they removed the whole bladder from him. So one of the class helped me how to get care of his stomach and help him through that. So I really respectfully ask request your to support for Issue Number Five.

Thank you. Thank you for being a caregiver.

Thank you.

My name is Tracy Hammond, and I'm from Yuba County, and I'm an IHSS worker, and I believe the Career Path is very important to have training for the work that we do.

Thank you.

My name is Audrey Williams. I am a care provider. I have been for eight years. I take care of my mother who is disabled. The Career Pathways is very important to providers like me because without it we wouldn't really know where to go or what to do when it comes to our clients and that's the most important thing for us. Thank you.

Thank you so much.

Good afternoon. My name is Carlos Tossy. I'm an IHSS provider for my fiancé from Calaveras County Angels Camp, and I look forward to participating into Career Pathways, and I think if we communicate out to more providers, we could spend more of that money.

Thank you, sir.

Good afternoon, Committee Members. My name is Cory Crocin. I'm an IHSS provider from Merced County where I provide care for my special needs client in my community. I have been an IHSS provider for 16 years, and I've seen a lot of changes, some good, some not so good.

But the IHSS Career Pathways Program is good, and extending the training is very beneficial to IHSS providers, and I'm asking for your support on extending the Career Pathway Program and to also lift the state participation cap on IHSS wages so providers can negotiate livable wages and benefits. Thank you.

Thank you.

Good afternoon, Madam Chair and Committee Member. My name is Pakamon Sopajaree. I am IHSS provider for Merced County. I taking care of my mom since 2014. I am here to respectfully ask for your support for the Issue Five: IHSS Home Care Pathway--sorry--IHSS Care Pathway Program and Issue Eight. And I believe in long life learning and I think everyone be our career. We want to be the professional. So please considering about this program.

Thank you.

Thank you so much.

Good afternoon. My name is Greg Barney. I'm a retired military member and IHSS provider from Merced County. I respectfully request your support for Issue Five, the IHSS Career Pathways Program and the IHSS state participation cap on the Issue Eight. Thank you.

Thank you for your service here.

All right. Thank you.

Good afternoon, Madam Chair and Members of the Committee. Malik Bynum with UDW/AFSCME Local 3930. Grateful for the discussion today and the inclusion of the Career Pathways Program and the state participation cap proposal in the agenda, which has echoed the remarks made by my colleague Tiffany Whiten.

But just add that 200 million of the 295 million dollars are General Fund dollars and not subject to the same 2024 deadline, and would just also just echo the remarks of all of our incredible providers up here. Respectfully request your support on these proposals as they move through the budget process. Thank you so much.

Thank you.

Good afternoon. My name is Jill Freeland. I'm an IHSS provider, Amador County, Calaveras County. I'm also on the bargaining team for SEIU 2015 and an active participant in the Career Pathways Program. And each of the pathways requires an amount of time to complete to get the incentive at the end.

So the extension of that would allow us to receive those, which is a bonus for us since we don't make a whole lot of money as a provider and I'm in the middle of a pathway I haven't completed yet. And at the end, there'll probably still be plenty of funds left for everybody.

Thank you so much.

Good afternoon. My name is Joseph Montez. I'm an IHSS caregiver and I'm also asking you for the support of the Career Pathway Program. Also, I found it to be very beneficial to the everyday, daily care to ER situations, which has helped me very much in my knowledge of taking care of my recipients. Thank you.

Thank you, sir.

Good afternoon everyone. My name is Fadian. I come from Sacramento County. I'm an IHSS provider, and I'm taking care of my parents who had dementia and diabetes. Since I took many courses from the Care Pathway Program, I know a lot of knowledge and how to take care of my parents better, and now they feel a lot better. So I want to say please keep going to support the program.

Thank you. Thank you so much.

Thank you.

Good afternoon, Madam Chair and all. My name is Stacey Trinidad-Afar. I'm a social worker trainee for Los Angeles County, member of the SEIU Local 721. Last year my caseload was 320 cases. This year, my caseload is 550 plus. That's why I'm here like my other colleagues in support of the bridge funding one-time ask of 51 million dollars. For IHSS in the meantime, the methodology gets updated and the IHSS program is appropriately funded.

This week, we also met with other legislators and have kindly requested to keep IHSS in mind when medical updates are made, such as the expansion of Medi-Cal for it directly impacts IHSS. The IHSS program serves as a cushion for the state to avoid high cost long-term care and costly hospitalizations. Thank you for your support. I have a leave behind, if you can kindly accept it.

You could give it--hand it to the sergeants over there. Happy Social Work Month. I don't even know if it's happy because you have 300 cases. 500 cases. Oh my gosh. Definitely not Happy Social Worker Month.

Hello. I'm Susanna Avagyan, and I'm also a social worker for In-Home Supportive Services with Los Angeles County, and I'm also in support of the proposal by CWDA, and I agree with my colleague's statement earlier. Thank you. Thank you for your time.

It's rough. I mean, two MSWs were licensed over there. It's rough. I hear you. Go ahead.

Sorry. Good morning. My name is Maria Vazquez from In-Home Support Services, social worker for Los Angeles County, member of SEIU Local 721, and I'm here also agreeing with my colleagues regarding the CWDA proposal. Thank you for your time.

Thank you.

Good morning, Committee Members. My name is Fontel White. I am a social worker with In-Home Support Services, Los Angeles County. Yes, Happy Social Workers Month, and I do align my support with my fellow colleagues, and I yield to the floor. Thank you.

Thank you, social workers, for coming up here. I know y'all do everything under the sun.

Good afternoon, Madam Chair, Senators. My name is Steven Gimian. I am ACIU Executive Board Member and also IHSS Social Services Supervisor, and we were here yesterday to talk to your staff, and we thank you and your staff for helping us. In this 35 years in my experience, I never seen such a wonderful collaboration between the ACIU and the Administration working together. Here we are today and for one cause only, to help the elderly and disabled.

Thank you, sir. Thank you.

Thank you.

Good afternoon. My name is Ryan Brama. I'm a Regional Director from DPSS, Los Angeles County. I'm here to express my support for CWDA's bridge funding.

Thank you.

Good afternoon. My name is Monica Shim. I am a Regional Manager for LA County DPSS in support of the CWDA and the updated methodology. Thank you.

Thank you. Did y'all take a bus from LA County? LA County's in the house.

We actually did. No, I'm kidding. My name is Carla Shaw. I'm a Regional Director with Los Angeles County's In-Home Supportive Services Program, and I'm here in support of the CWDA's proposal for the 51 million and an update in the methodology. Thank you.

Thank you so much.

Good afternoon. My name is Jennifer Kaiser, and I am an instructor through Homebridge for Career Pathways. I can't give you budget numbers, but what I can tell you is that I teach 60 classes a month and every single one of my classes is filled. These are skill-based classes for these folks, and the waitlists are also full for those. And every time I teach a class, I have somebody telling me how important this is for them.

There are many, many parents who are taking care of disabled children or disabled parents who have dementia, and they need these to keep them out of the hospitals and out of the facilities. Thank you so much.

Thank you so much.

Hello, everyone. My name is Gwynetta Cook Huddleston. I'm also an instructor at Homebridge, and I'm proud to teach the mental health courses. I don't have to explain to you guys the importance of educating people on mental health. My caregivers are getting a lot out of this. They're empowered. Just the other day I had a student tell me that I was able to recognize major depression in my consumer because of your course, so I can get my consumer help. I'm asking you to extend the program and be a part of continuing this narrative.

Thank you so much for sharing.

Hello. My name is Priscilla Cariaso, and I work for Homebridge, which is implementing the IHSS Career Pathways Program. I'm here to express my deep support for the extension to the program. I work daily with the providers, getting them into the courses and everything, and the main message to them is that they need more and want more. Thank you.

Thank you.

Good afternoon, Madam Chair and Senators. My name is Erin Siberry. I'm representing Homebridge, one of the providers of the Career Pathways Program. We've been honored to do a huge ramp up for this training. We want to thank the Senate, the Legislature, and the Administration for the vision in supporting the caregiving workforce at this juncture, when we have a growing number of older adults and people with disabilities who need quality care. We see it as a lifeline of helping people to stay and remain housed and at home with the kind of care they need, so thank you for your support for Career Pathways.

Thank you so much for coming.

Good afternoon. My name is Cheryl Ward. I'm the Division Chief for IHSS LA County, and I'm here to support the CWDA bridge fund. And just so you know, we have a total of between 550 and 650 cases, and we're one of the very large counties, so you can imagine. And we want to provide quality care, and we also need to change in the mythology.

Thank you.

Thank you.

Good afternoon, Chair, Members, and staff. My name is Leza Coleman. I'm with the California Commission on Aging. Last year, the Commission had a forum on housing. Dr. Krishelle was one of our keynote speakers. So I want to bring to your attention the home safe program. The state has put the investment in, it has been established in the communities, and it is doing good. It would be short-sighted to take that away. Also with the CCE program, we are seeing positive results in that area.

When we talk about people being institutionalized, some of that institutionalization is going into CCE, our residential care facilities for the elderly, and that is a significantly less expensive program than going into skilled nursing.

Thank you.

Good afternoon, Chairman and Members. My name is Aida Karapetian, and I am a Regional Director from LA County. I'm here to kindly ask for your support for the 51 million, and also for the new methodology to be created, which is a recommendation from CDSS. The new methodology is needed because current methodology is not including all the workload that our workers are doing.

For example, 7,000 applications that were received by LA County last in the month of January, which was 27 percent increase from the 2020 January, is not included in the current methodology. Thank you.

Hello, Madam Chair, and to the Committee, my name is Monica Kirkland. I am the State Policy Director for Alameda County Senior Services Coalition of Alameda County, and I am here to just--we've experienced a lot of individuals that are part of our organization, which represents over 40 nonprofit and community-based organizations that have been impacted by Home Safe, and that includes legal services, housing of such. And because of that, we are asking for a commitment to continue funding in that arena, and also we are opposed to the delayed funding for--

Thank you.

Thank you.

Thank you, Madam Chair and Members. Andrew Shane, End Child Poverty California. We align with SEIU and CWDA on IHSS and with the Californians for SSI, on their request, I would just remind that it's often overlooked. There's nearly 100,000 children on SSI, and so we can't achieve our mission to end child poverty without increasing those SSP grants.

Thank you.

Hello. My name is Monique Hooks. I'm the Executive Director at DayBreak Adult Care. We are a Home Safe provider in Alameda County, and I would just like to echo that Home Safe funding is vital for the elders in our community who are the most vulnerable, as well as the supportive services that go along with it.

Thank you so much for your comments.

Hi. My name is Robert Copeland. I belong to the SSI Coalition. There's a lot of people on SSI that are at risk of becoming homeless or live with substandard housing. So increase the COLA amount and also properly fund the Home Safe and HDAP programs. That will help a lot of people that are homeless. Thank you.

Thank you so much. Seeing no other public comment, we're going to move on to the next department: Department of Community Services and Development, starting off with the Issue One and the only issue under this Department: Federal Trust Fund Authority Augmentation. CSD, you may begin. No.

No. It's on now? Okay. Thank you. Good morning. I mean, good afternoon, Madam Chair and Members. I'm Jason Wimbley, the Acting Director of the Department of Community Service and Development, and thank you for the opportunity today to present CSD's budget change proposal. The mission of CSD is to reduce poverty in California through the administration of programs designed to strengthen the economic security of vulnerable, low-income Californians.

We work with community partners across the state to help low-income Californians meet their basic needs, achieve economic independence, manage their home energy costs, and reduce their energy use through energy efficiency upgrades and access to clean renewable energy. Our primary programs are federally funded block grants, such as the Community Services Block Grant and the Low-Income Home Energy Assistance Program. We administer federal and state funded weatherization and energy efficiency programs for low-income households, including farm workers and multifamily affordable housing.

We have one budget change proposal this year. It proposes increasing the Department's Federal Trust Fund baseline authority for local assistance to better align with the current funding levels for our core federal grants. If approved, this BCP will eliminate the need for CSD to engage the Section 28 process to secure additional authority and ensure a timely release of federal grant funds by the Department to its network of community partners or subgrantees. There is no funding associated with this BCP, so I thank you for your time today and happy to answer any questions you may have.

LAO, any comment?

Yes. Angela Short, with the LAO. We've reviewed the Department's BCP and we find it reasonable for a few key reasons. First, as you heard from the Department, it seeks to align CSD's current--excuse me--federal expenditure authority with its actual anticipated award amounts. Second, the Department is proposing that this would be limited term and they would review the increased authority in three years and adjust as needed.

And then finally, regarding the Section 28 letter process, this process is intended to ensure that the Legislature is informed when a Department may receive unanticipated federal dollars above the baseline awards. But in this case, the Department is anticipating that its awards will continue to exceed current baseline authority. So for these reasons, we find the proposal to make sense. Thank you.

Thank you so much. Would you like to add any other comments, Department of Finance?

Omar Sanchez, Department of Finance. Nothing further to add.

Okay. Nothing further on our end. We're going to hold the item open. Thank you so much, CSD, for coming up. We're moving on to our last department of the day: Department of Aging.

Good afternoon, Madam Chair. Senator Roth, Senator Eggman. I'm Susan DeMarois, Director of the California Department of Aging. I'll be addressing the first three questions on the agenda, and our Chief Deputy, Mark Beckley and Deputy Nicole Shimosaka will follow with the balance of the items. So the first question. The proposed CDA budget reflects a leveling of our work following the department's unprecedented growth over the past few years.

As we responded to the Covid-19 pandemic and formalized our lead role in standing up the Governor's Master Plan for Aging. Our hardworking CDA staff is diligently stewarding 46 new and one time initiatives made possible by federal ARPA and HCBS dollars, as well as General Fund support. Simultaneously, we are positioning the Department to meet the needs of one in four Californians who will be aged 60 or older by 2030.

CDA, in close partnership with local agencies, offers a wide range of core programs to older adults, people with disabilities, and family caregivers. Our Department supports the population in four ways. We connect, support, protect, and convene. We connect people to information, assistance and referrals, directing individuals and families to the coverage, benefits, and services they need to age in place at home, in their community.

We support individuals and families with nutritious meals, caregiver education and respite legal services and two Medicaid waiver programs, adult day healthcare and multipurpose senior services. We protect individuals with our newly established Office of the Patient Representative and the Long-Term Care Ombudsman Program, led by Blanca Castro. We convene stakeholders to ensure equity is at the center of our work, addressing disparities based on age, disability, race, ethnicity, language, immigration status, gender identification, sexual orientation, income, veteran status, rural geography, and other demographic characteristics.

Move now to question number two. Please provide an overview of the latest Master Plan for Aging report. We were proud to present the third annual Master Plan for Aging report to the Legislature on January 25. This document summarizes California's whole of government, whole of society approach with continued engagement with the Governor, senior advisor, cabinet secretaries, state departments, stakeholders, community based organizations, and philanthropy. A few items of note.

We've deepened our ties to local government with 21 Local Aging & Disability Action Planning Grants, and we've broadened our scope to include a number of strategic federal partnerships relating to housing and homelessness, Alzheimer's and dementia, and streamlining services under a No Wrong Door leadership council. We've sharpened our focus on equity, developing our first MPA equity framework and equity index, both foundational to our work to produce benchmarks and key outcome measures.

And we are proud to have welcomed the department's first Tribal Affairs Manager and launched California's first ever LGBTQIA+ older adult survey with support from the LGBTQ caucus. And we're pleased to report that we've had over 3500 respondents to date and our goal was 2000. We remain committed to transparency with our real time Master Plan for Aging Initiative Tracker and Data Dashboard on Aging.

In the past year, we welcomed the oversight of the Little Hoover Commission at two public hearings, and we continue to align the Administration with the MPA Impact Committee, a stakeholder group that monitors our progress and results. And finally, on the policy front, we're accelerating our MPA work related to long term services and supports. LTS has system change with initiatives underway related to navigation, access, workforce and affordability.

We are partnering with the Department of Healthcare Services on the state's first home and community based services gap analysis and roadmap. And our Cal grows initiative offers free caregiver training in nine languages, with over $2 million awarded to direct care workers in incentives to date. Just this week, we signed a contract to embark on the very important work authorized by the Legislature to collect data and explore financing solutions to meet the growing needs of the missing middle or forgotten middle population. Move to question number three.

Director, even though I joked earlier about being here till 10, I actually do also have time restraints for a flight. So we're going to skip number three.

Okay.

And move on to number four.

Okay. In that case, I'm pleased to turn the microphone over to Mark Beckley, our Chief Deputy Director.

Great. Good afternoon, Madam Chair and Members. My name is Mark Beckley. I'm the Chief Deputy Director for the Department. So, an update on the Bridge to Recovery Program. So, the Bridge to Recovery Program, its goal was to provide an opportunity for centers to resume in center congruent surfaces post pandemic to help meet the needs of the most vulnerable Californians and their families through our community based adult services, adult day and programs for the care for the elderly, or PACE programs. Some of the items that are eligible to fund under this initiative include stipends and trainings for staff and infection control, infrastructure changes and equipment.

To date, 357 grant applications have been awarded, with 317 applicants accepting their grant awards. We're currently working on the contracting process with these awardees. To date, we have finalized and sent out grant contracts for 74 of these centers. There is 84 contracts that are currently in the process of being executed, and we have an additional 159 contracts that are currently under review. It's our goal to have these contracts completed by the end of this month. That's my update.

Thank you so much. Department of Finance, any additional comments?

Ty Ulrey, Department of Finance nothing to add.

LAO?

Okay, there we go. Juwan Trotter, Legislative Analyst Office. We have nothing to add at this time.

Thank you.

Just excited about the survey that's going out, that's all.

Okay. Thank you so much. We're going to move on to issue number two. For issue number two and issue number three, we can do a short presentation on both of these.

No problem. Good afternoon, Madam Chair and Members. Thank you. Nicole Shimosaka, Deputy Director of Administrative Services. So for Healthier at Home reversion, this was a $12.5 million pilot, $10.6 million was going to go to the locals. The balance was going to be for our Administration. At this time, we've only spent $610,000 on Administration.

The intent of this would have been that seven specified counties would have received registered nurse and community health workers at selected senior affordable housing sites with the goal of just helping these folks within these affordable housing sites to avoid institutionalization and age in place. This was not a pilot that provided housing or anything of that nature. This was to empower them with health system navigation, chronic condition disease management coaching, things of this nature that would again, just help them to age with dignity in their homes. At this time, we've not initiated the local work, so there is not an impact to the locals.

Thank you. Department of Finance.

Tyler Ulrey. Department of Finance. I just wanted to echo those comments. Given that this budget solution doesn't disrupt any local services and given some other obstacles identified by CDA and their work with stakeholders, we felt that this was an important budget solution.