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San Diego County: Reforming Its IHSS Program

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Published on Apr 16, 2012

Escalating IHSS costs and concerns about program integrity triggered the San Diego County Board of Supervisors to call for reform; these reform efforts have resulted in significant cost savings. The county initiated a complete review of the IHSS program. Work undertaken included contracting with a third-party organization to complete a data analysis, creating a staff work group and involving community and internal stakeholders. A series of recommendations were present to the Board of Supervisors and adopted. These included creation of a county plan for a new program integrity initiative; initiation of individual provider enrollment, including criminal background checks; and pursuit of an integrated system of long-term care that would create wrap-around services to blend funding for health and social services, reduce gaps in care and remove barriers for clients served by both Medicaid and Medicare. As a result of these and other measures, program cost growth for IHSS has shrunk from an average of 8-10 percent annually to .2 percent. Annual budget expenditures were $24 million less than projected.

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