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Adult Services Funding Streams and Their History
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- Overall Funding Streams
- Federal Funding
- Community Services Block Grant (CSBG)
- Elder Justice Act and Older Americans Act
- COVID-19 and ARPA Funding
- State General Funding
- Realigned Funding
- Program Specific Funding Details
- County General Fund
- Grants
- Sec.1 | Resources
- Adult Protective Services programs are funded with Federal funds, 2011 Realignment State Funding, and County General funds.
- IHSS is funded through Title XIX, 1991 Realignment State Funding and moved to the new MOE model, making the State share varied.
- FEDERAL FUNDING
- “Titled” federal funding is received by the state and distributed to counties based on the methodology of each allocation. The Title number refers to the number assigned to the specific need that is being addressed.
- State and County funds are used to draw down or “match” federal funding.
- Federal Year is October 1- September 30
- Federally funded prevention funds that flow through counties
- Examples of Federal Funding:
- Community Services Block Grant (CSBG)
- Elder Justice Act
- Older Americans Act
- COVID-19
- ARPA
- Titled federal funding for Adult Services includes:
- Title XIX – open ended entitlement; provides partial coverage for referrals and case work for Medi-Cal eligible or potentially eligible dependent children for health, mental health, substance abuse treatment and health related Social Services. It also provides 75% reimbursement for Skilled Professional medical personnel and 50% reimbursement for health related services and activities.
- COMMUNITY SERVICES BLOCK GRANT (CSBG) & SOCIAL SERVICES BLOCK GRANT (SSBG)
Articles to support Segment:
- ELDER JUSTICE ACT AND OLDER AMERICANS ACT
- The Elder Justice Act (EJA) was signed into law by President Obama on March 23, 2010, as part of the Patient Protection and Affordable Care Act. It aims to prevent, detect, treat, understand, intervene, and, where appropriate, prosecute elder abuse, neglect, and exploitation. As of 2024, the EJA has never been fully funded by the federal government.
- The Older Americans Act (OAA), established in 1965 to provide social services for older adults, now organizes and provides funding for a wide variety of services for this demographic and their caregivers. OAA is administered by the Federal Government Department - Administration for Community Living.
- On July 31, 2024, the U.S. Senate Committee on Health, Employment, Labor and Pensions (HELP) approved the bipartisan Older Americans Act Reauthorization Act (OAA) of 2024 (S.4776) on a 20-1 vote. The OAA was last reauthorized under the Supporting Older Americans Act of 2020 (PL 116-131), which was set to expire on September 30, 2024. S.4776 would reauthorize the OAA, which funds critical programs and services that help older adults live independently in their communities. County governments are key recipients of OAA funding and have long called for Congress to reauthorize and fully fund OAA programs so that we can meet growing demand for services.
- On December 10, 2024, the U.S. Senate passed the Older Americans Act Reauthorization Act (OAA) of 2024 (S.4776) by unanimous consent. If signed into law as-is, the legislation will reauthorize Older Americans Act funding from $2.3 billion this year to $2.76 billion in Fiscal Year 2025, a 20% increase compared to last year. As of January 2025, while reauthorized and funding recommended to be increased, OAA is in jeopardy of being affected if there is a government shutdown.
- The Older Americans Act supports many initiatives, including:
Articles to support Segment:
- AMERICAN RESCUE PLAN ACT (ARPA) of 2021 & CORONAVIRUS RESPONSE AND RELIEF SUPPLEMENTAL APPROPRIATIONS ACT (CRRSA) OF 2021 COVID -19
- As part of the American Rescue Plan Act (ARPA) of 2021, the Federal Administration for Community Living provided funding to California to enhance the protective services offered by APS in the investigation and remediation of instances of abuse, neglect, and exploitation. The California APS program received two ARPA grants throughout the 21-22 and 22-22 fiscal years totaling $25.1 million, with both allocations available until September 30th, 2024.
- APS programs received federal funds to improve their protective services to meet the unique needs created by the COVID-19 pandemic through the Coronavirus Response and Relief Supplemental Appropriations (CRRSA) Act of 2021.
- STATE GENERAL FUNDING/ ALLOCATIONS
- State fiscal year is July 1- June 30
- The State budget delineates how much State General funds will be available – State General Fund is used to draw down Federal dollars.
- Allocations letters delineates how much each County will receive.
- Allocations, Counties are allocated funds based on various methodologies.
- Allocations are issued via a County Fiscal Letter which describes the methodology used to determine the allocation, claiming instructions for costs associated with the allocation, and the program codes associated with the allocation.
- Adult Services Program will have specific allocations to their programs and some have a Sharing Ratio.
- Some allocations have a Sharing Ratio that defines the percent of the allocation that is supported by federal, state or county dollars (Federal/State/County).
- Some allocations are open-ended, that is, the amount of the allocation is not capped but will cover all costs incurred for the specific purpose of the allocation.
- Other allocations are capped, that is, there is maximum amount that will be given for the program or activity.
- If the County’s costs exceed the allocation, the activity/program is “Overmatched” when county funds permit. Overmatching should not happen accidentally. It is a decision that may involve the Agency Department head, the County Administrative Officer, and/or Board of Supervisors.
- Allocations can fund:
- Specific programs and/or activities
- Administrative costs (including staffing and benefits), services or a combination of these.
- Each allocation has a methodology defined by California Department of Social Services (CDSS) methodology that identifies the county share and the federal and state participation in costs.
- Allocations can be:
- Reimbursement for actual cost of benefits and payments for specific programs
- Reimbursement for expenditures for funded activities or services (costs are submitted via CDSS Claim forms)
- Prorated share of the total state budgeted amount based on the caseloads or staff activities captured in Time Studies.
- Home Safe
- Fifty-eight (58) counties operate a Home Safe program, and each program is tailored to meet the needs of the local community. Twenty-three tribal grantees operate a Home Safe program. For more information about county funding, refer to CFL 22/23-43 (January 20, 2022). Tribal grantees were issued individual allocation letters on a rolling basis as Memorandums of Understanding (MOU) were executed.
Articles to support Segment:
- STATE GENERAL FUNDING/ REALIGNED
- State funds also provide a share of funding for various programs, services and activities.
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- The State moved to realigned funding for IHSS in 1991 and APS in 2011. The reason for moving to realigned monies were Funding sources were not stable, each year the state budget would determine the APS allocations.
- Realigning Sales Tax and Vehicle License Fees (VLF) to cover the State and County Share of costs of Social Services programs.
- Adult Services is funded with two Realignment pool
– 1991 Realignment - IHSS
– 2011 Realignment – APS
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- Each allocation was separate and could only be used as it was defined for that allocation (there was no flexibility to move funds between allocations);
- Allocations not spent were redistributed to counties who had “overspent” their allocation.
- In a strong economy realignment provides for growth.
- According to statute, growth must be used to fund the programs included in each realignment account.
- 1991 Realignment State Funding for IHSS
- Other programs that were affected by 1991 Realignment – CalWORKS, Foster Care, Adoptions Assistance and Mental Health to name a few.
- There are two dedicated revenue sources to fund the programs:
- A one-half cent increase in the State sales tax
- An increase in vehicle license fees
- 2011 Realignment State Funding for APS
- Other programs that were affected by 2011 Realignment – Child Welfare, Law Enforcement, Drug Court and Mental Health to name a few.
- Did not change mandates -- counties are still responsible for the same mandates;
- Stabilized the funding source and dedicated a portion of the sales tax and vehicle license fees for APS.
- Instead of State General fund allocations, Counties will receive a % of 2011 realignment funding.
- Increased risk to Counties if sales tax and VLF do not materialize
- IHSS FUNDING
- IHSS Costs Split Between Federal Government, State, and Counties. IHSS costs are shared by the federal government, state, and counties. Since IHSS primarily is delivered as a Medi-Cal benefit, the federal share of costs is determined by the Medicaid reimbursement rate, which typically is 50 percent. The state receives an enhanced federal reimbursement rate for many IHSS recipients who receive services as a result of the Patient Protection and Affordable Care Act expansion (90 percent federal reimbursement rate) and the Community First Choice Option waiver (56 percent federal reimbursement rate). Overall, the effective federal reimbursement rate for IHSS is 54 percent. The remaining nonfederal share of IHSS costs is covered by the state and counties. Historically, counties paid 35 percent of the nonfederal share of IHSS service costs and 30 percent of the nonfederal share of IHSS administrative costs. Beginning in 2012-13, however, the historical county share-of-cost model was replaced with an IHSS county maintenance-of-effort (MOE), meaning county costs reflect a set amount of nonfederal IHSS costs as opposed to a certain percent of nonfederal IHSS costs. The state is responsible for covering the remaining nonfederal share of costs not covered by the IHSS county MOE.
- A MOE is a set level of County financial responsibility
- Programs with MOE’s:–IHSS
- Overspending capped allocations can cause the County to exceed their MOE.
- The county will never pay less than the MOE.
- In the 2017 legislation (SB 90, Chapter 25, Statutes of 2017) that established the increased County In-Home Supportive Services (IHSS) Maintenance of Effort (MOE), CSAC advocated for a provision that required the Department of Finance to reexamine the 2017 IHSS fiscal structure during the development of the 2019-20 budget. This reopener provision was absolutely vital as counties knew that it was likely possible to manage the first two years of the new MOE, but starting with 2019-20, the increased costs would become unsustainable.
- In conjunction with the release of the Department of Finance report in January 2019, the Governor released a proposal to revise and lower the County IHSS MOE. CSAC strongly supported this proposal, which was enacted into law through a budget trailer bill, Senate Bill 80 (Chapter 27, Statutes of 2019), and made several significant changes to the County IHSS MOE. These changes are:
- Lowering the County IHSS MOE base in 2019-20 to $1.56 billion,
- Reducing the MOE inflation factor from seven percent to four percent,
- Stopping the redirection of VLF growth funds from Health, Mental Health, and County Medical Services Program to Social Services,
- Ending the State General Fund IHSS mitigation,
- Returning to the original method for calculating IHSS caseload and no longer utilizing accelerated caseload growth, and
- Funding IHSS administrative costs through a General Fund allocation.
Articles to support Segment:
- APS FUNDING
- Prior to Realignment
- Adult Services was funded by multiple separate allocations,
- Funding sources were not stable, each year the state budget would determine the Adult Services allocations;
- Each allocation was separate and could only be used as it was defined for that allocation (there was no flexibility to move funds between allocations);
- Allocations not spent were redistributed to counties who had “overspent” their allocation.
- 2011 Realignment
- In 2011, the State of California reorganized the distribution of funds to counties. It included two separate components:
- Child Protection Fund and Adult Protection Fund.
- A separate 2011 Realignment fund supports Mental Health.
- 2011 Realignment intended outcomes:
- Combined multiple funding allocations into a single funding stream umbrella.
- Reassigned the responsibility of 100% of the non-federal costs to the counties along with a shift of tax revenue to counties in lieu of state general fund.
- Funding for these programs now bypasses the state general fund and budget process entirely.
- In a strong economy realignment provides for growth.
- According to statute, growth must be used to fund the programs included in each realignment account.
- Did not change mandates -- counties are still responsible for the same mandates.
- Stabilized the funding source and dedicated a portion of the sales tax and VLF for Child and Adult Protection.
- Because the funding source is now dedicated, the amount of revenue is now capped based on the amount of sales tax and VLF collected.
- Benefits to counties
- Stable funding source from a dedicated revenue stream; however, this means the allocation is capped by revenues coming to the state and county from the VLF and sales tax. Shifts in this revenue impact the allocations.
- Counties cannot use Realignment funds to pay for activities outside the scope of 2011 Realignment allocations.
- More flexibility for counties to design their own budget within Adult Services statutes and regulations to support individual county budget needs.
- Challenges to Counties
- Realignment fund is capped; this is not an unlimited source of revenue
- Revenue may be down when program demands are on the rise
- VLF tend to be volatile
- CA SENATE BILL 2199
- Prior to the implementation of CA Senate Bill (SB) 2199 in 1998, APS was minimally funded and there were few statewide mandates or standards. SB 2199 created a statewide APS Program with statewide minimum standards and was implemented May 1, 1999. Major changes to APS due to the enactment of SB 2199 are:
- The definition of mandated reporters was expanded. Prior to SB 2199, medical personnel, care custodians, social workers and law enforcement agents were required to report elder and dependent adult abuse within the scope of their employment responsibilities. With the implementation of SB 2199, mandated reporters now include any person who has assumed full or intermittent responsibility for the care or 2 custody of an elder or dependent adult. This provision became effective in January 1999.
- APS agencies are now required to respond to and investigate all reports of physical abuse, financial abuse, neglect (including self-neglect), abandonment, isolation, abduction. Prior to SB 2199, mandated reporters were only required to report physical abuse of elders and dependent adults. APS agencies were authorized, but not required, to provide protective activities, such as investigations and need assessment. This provision also became effective in January 1999.
- APS agencies are required to operate a 24-hour emergency response system which provides in-person responses, 24 hours per day, seven days per week. The 24-hour system allows counties to provide immediate intake or intervention for new reports involving immediate life-threats and to respond to crises in existing cases.
- APS agencies are required to provide case management services which include investigation, assessment of individual limitations, strategies for stabilization, linkage to community services, monitoring, and reassessment. Prior to SB 2199, APS agencies would respond to, at a minimum, allegations of physical abuse, stabilize the situation, and utilize available social services and community resources. Counties were not required to conduct case management services.
- APS agencies are establishing emergency shelter care and in-home protection services in addition to tangible and non-tangible services, such as, emergency food, clothing, repair/replacement of essential appliances, transportation, etc. APS Funding: The APS Program has been funded under the Community Services Block Grant (CSBG) Program since 1984. In addition to funding APS, the CSBG allocation also funded other social service programs, such as Information and Referral, Out-of-Home Care Adults, and the Optional Services program. In SFY 1996/97, the CSBG total funds available were $35.5 million; the exact amount spent on APS is not reported.
- With the passing of AB135 in June 2021, California's APS services have expanded from being available to older adults age 65 and older to age 60 and older. This policy change became effective on January 1, 2022.
Articles to support Segment:
National Voluntary Consensus Guidelines for State Adult Protective Services Systems, Updated March 2020 (acl.gov)
- COUNTY FUNDING
- County General Funds are used to cover costs as follows:
- A mandated portion of assistance payments, i.e., Foster Care, Adoption;
- A mandated share of administrative costs.
- Overmatched costs (overspending in a specific area where federal and state funds do not provide sufficient funds to cover necessary costs, for example, Post 2011 Realignment).
- County Budgeting and Planning
- Every county will have its own budgeting process. Generally, county fiscal years start on July 1 and end on June 30 of the following year. The overall county budget includes the budget for every county department. The overall county budget development is overseen by the County Administrative Office (CAO). The CAO presents the budget to the County Board of Supervisors who will review it, discuss it in a board meeting(s), make changes if they desire, and approve it for finalization to guide the following year’s county operations.
- Questions to ask?
- When does your County’s Department Fiscal Planning begin?
- Who is involved in these meetings?
- Any changes from last year’s budget?
- Budget Justifications
- The Adult Services Director will have to submit a written justification for new expenditures or sometimes to continue other expenditures. These types of justification statements will vary in form according to the county’s requirements. Generally, however, the justifications will include a statement of what is needed (staff, equipment, client services vouchers, contracted services, etc.), its cost (in total and the county contribution), what will be provided, if it is a requirement, why it is needed, and the difference it will make.
- These justifications are usually reviewed by the department’s fiscal officer, the department’s director, and a decision is made as to whether the department will support the request and present it to the County Administrative Office for consideration and inclusion in the county budget. How much attention is given to the new request and justification depends on many factors, starting with the size of the request.
- Although ultimately the final budget decision is made by the Board of Supervisors, it is essential that the Adult Services Director represent and articulate budgetary needs accurately and clearly. The approved CWS budget plays a significant role in determining Adult Services performance and effectiveness, e.g., are there enough staff to deploy? the right types of staff? Enough services to offer clients? Etc.
- Budgeting Tools
- The Adult Services Director should find out what tools, reports, and statements are used to manage the budget for his/her county. A good starting place is to look at the Adult Services budget for the current year and last year.
- Relationships are also a good “tool.” Ask the department’s fiscal officer to review these documents with you at least a “big picture” level.
- One ongoing challenge in many counties is what many describe as a lack of communication between the “program people” and the “budget people.” To reach out to the fiscal officer early will convey a willingness by the Adult Services Director to work in a fiscally responsible manner and it also begins a constructive relationship between the fiscal and program arenas.
- You will want a copy of your budget, all monthly and quarterly fiscal reports that affect your budget (e.g., reports on contracted services, CEC and time studies reports, etc.) Ask the Human Services/Social Services Agency Director (to whom you report) and the department’s fiscal officer what other reports are produced that will inform your planning and operations.
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