Development of IHSS Public Authorities
IHSS and IHSS Public Authorities are unique in the United States due in part to their admnistration and funding which involves County, State, and Federal governments, funding, regulations, and laws. IHSS, created in 1973, provides housecleaning, meal preparation, laundry, grocery shopping, and personal care services to nearly 700,000 in 2022, low-income consumers who are elderly, blind, or living with disabilities and who are unable to live safely at home without assistance. In 2022, IHSS employs nearly 600,000 home care workers across California.
While workers in America who want to improve their wages and benefits can organize a union and bargain with their employer, this was not always the case for IHSS workers. In 1987, California courts, in an SEIU suit, held that homecare workers were not employees of the state from whom they receive their paychecks nor of the county to whom the workers submit their timesheets, rather the court said IHSS workers are independent contractors and have no employer with whom to bargain for wages and benefits. (New York Times, 1999).
With these conditions, IHSS consumers were often unable to find providers and had difficulty in keeping their providers--both of which are essential to a consumer’s quality of life and ability to survive living independently. Workers were not available; the turnover was high and continuous. There were no provisions for emergencies to replace a provider who did not or was not able to show up for their shift. There was no employer of record that would allow IHSS workers to organize for wages above minimum wage. Additionally, the Little Hoover report (1991) cited the need for more funding to hire social workers and improve case management.
These realities and dynamics resulted in a 1992 legislation to allow counties to establish a non-profit entity, an IHSS Public Authority, to oversee the delivery of IHSS in the county with a mandate to create a registry of IHSS workers and act as the employer of record for IHSS providers. SB 485 was passed and signed into law by Governor Pete Wilson.
In an effort to establish an IHSS Public Authority, senior and disability advocates, in several counteis, joined with labor to establish work groups and task forces that created the groundwork for change to implement create a Public Authority. They worked together to articulate the major consumer issues in their county; discussed and formulated ideas on how the non-profit entity would operate; debated how consumers could maintain influence and oversight of the entity; and met with their County Board of Supervisors to realize their goals and plans. Between 1992 when the legislation passed and 1998, several counties, Alameda, Contra Costa, Los Angeles, Monterey, San Francisco, San Mateo, and Santa Clara created an IHSS Public Authority which included the legisaltove mandates: a consumer-majority Governing Board or Advisory Committee; an employer of record for IHSS workers; a registry to help consumers and providers find each other; and access to training for consumers and workers. Several counties—Alameda, Contra Costa, San Mateo, and Santa Clara—chose to make the Board of Supervisors the Governing Board of the Public Authority and create a Consumer Advisory Committee to advise the Governing Board. Other counties—Los Angeles, Monterey, and San Francisco chose to establish their Public Authority with a Consumer-Majority Governing Board.
Throughout this period, a coalition was building between IHSS recipients, IHSS providers, advocates, family and labor with the recognition of the essential linkages between the worker and the consumer and recognition of paramount importance of the independent provider mode of delivery which allows consumers to hire, train, and fire workers rather than the contract mode where consumers have a worker assigned to them, with direction from an agency on work to be done with the consumer.
Initially, two unions—SEIU and UDW—were involved with the IHSS workforce—SEIU (Service Employees International Union) supported the independent provider mode and UDW (United Domestic Workers) supported the contract mode. In time, both unions have supported the independent provider mode. With the abililty for the Public Authority to be the employer of record, SEIU conducted membership drives in several counties. Once a majority of workers signed to be union members, SEIU would ask for an election culminating in union contracts in Alameda, Contra Costa, Los Angeles, Monterey, San Francisco, San Mateo, and Santa Clara Counties.
SEIU and UDW faced challenges to organize this fragmented workforce without a work site and with high turnover. IHSS Consumers were concerned the unions would only focus on wages and benefits and would ignore consumer concerns. Working together as consumers, providers, advocates and family members, and labor, the IHSS Public Authority model eventually won the support of a many who originally opposed the Public Authority system. The IHSS Public Authority is a public agency, overseen by a consumer-majority board and whose purpose is to make IHSS work better for consumers and providers. Very imortantnly, the 1992 Public Authority legislation offered a large-scale opportunity to demonstrate that the consumer-directed, or independent provider, mode of delivery could be a viable, cost effective, non-invasive way to provide in-home care.
In 1999, the seven initial Public Authorities, both SEIU and UDW, and IHSS activists from around the state successfully advocated for additional legislation that permanently changed California’s IHSS program. The stunning two-fold victory included: dedicating new state monies to fund substantial wage and benefit increases for IHSS workers over five years; and mandating a framework that resulted in the proliferation of the Public Authority model of IHSS delivery. With labor, consumers, families, and advocates pulling together in a united voice, and to the amazement of many, at the 12th hour, AB 1682 became law and mandated involing both worker and consumer—by mandating that the Public Authority be an employer of record for providers and mandating that the Pubilc Authority have a Consumer Advisory Committee or Governing Board with $56,000 a year funding.
With the mandate required in AB 1682, today nearly all 58 counties have an IHSS Public Authority. The Public Authorities joined together to form the California Association of Public Authorities (CAPA) to provide leadership to improve the IHSS program and to promote the interests of its county-based Public Authorities. CAPA is made up of Public Authority Directors. Eventually, Consumer Advisory Committees and Governing Boards joined together to form CICA (CA IHSS Consumer Alliance).
The formation of the Public Authorities and union representation has resulted in:
Collective bargaining in IHSS allows providers to bargain to improve wages and benefits;
Unions collaborate with other advocates to fight program cuts and lobby for improving IHSS;
Providers receive higher wages, limited health insurance, overtime, medical accompaniment pay, travel time;
Optional automatic deposit and electronic timecards are available to providers;
Public Authority registries help match consumers and providers;
Some counties have back-up registries to offer temporary replacement providers during emergencies;
Basic training classes are offered to providers and consumers; and
Screening and background checks for providers have been implemented.
The history of IHSS and the Public Authority system is long and complicated with myriad organizations, constituencies, and individuals playing spectacular roles in the on-going effort to create a program that works and responds to current conditions and demands and works for consumers and providers. CICA acknowlledges the many contributors to these sections on the history of IHSS, public authorities, and CICA including Bob Roberts, Nancy Seydon, Frances Gracechild, Bud Sayles, Patricia Yeager, John Chan, Kristine Loomis, Janet Heinritz-Canterbury, Janie Whiteford, and Hale Zukas. Click on “Contact Us” if you have comments regarding these website pages.