Increase/ General Fund Actual Approved Requested Recommended (Decrease)

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1 Michael Miller, Director Increase/ General Fund Actual Approved Requested Recommended (Decrease) Expenditures Salaries & Benefits $77,812,110 $100,758,024 $106,925,507 $106,925,507 $6,167,483 Services & Supplies 44,133,070 50,517,329 54,044,456 54,044,456 3,527,127 Other Charges 171,918, ,091, ,127, ,127,026 12,035,883 Fixed Assets 57, , , , ,390 Operating Transfers Out 594, , (610,000) Total Expenditures $294,514,497 $327,623,106 $349,036,989 $349,036,989 $21,413,883 Expenditure Reimbursements (3,767,519) (3,557,034) (3,789,273) (3,789,273) (232,239) Total Appropriations $290,746,979 $324,066,072 $345,247,716 $345,247,716 $21,181,644 Earned Revenues By Source Aid from Other Governments $278,259,640 $309,450,775 $329,132,925 $329,132,925 $19,682,150 Miscellaneous Revenues 639, , , ,961 (100,000) Operating Transfers In 2,184,056 1,226,172 1,226,172 1,226,172 0 Total Revenues $281,082,881 $311,367,908 $330,950,058 $330,950,058 $19,582,150 Net County Cost $9,664,098 $12,698,164 $14,297,658 $14,297,658 $1,599,494 Allocated Positions , , , Temporary (Full-Time Equivalent) (1.4) Total Staffing , , , Purpose The Human (HSA) provides State and Federal-mandated public assistance and a variety of social service programs for the citizens of San Joaquin County. Programs include: California Work Opportunity and Responsibility to Kids (CaIWORKs), Foster Care, Cal- Fresh, General Assistance, Medi-Cal, Adoptions, Child Protective Services, Adult Protective Services, In-Home Supportive Services (IHSS), Refugee Assistance, and the Mary Graham Children's Shelter. Federal and State legislation and local regulations govern the methods by which resources of the Agency are allocated. This budget reflects the combined administrative and financial assistance program costs, and funding for the public assistance programs administered by the HSA. Major Budget Changes Salaries & Employee ~ $1,497,922 ~ $3,674,791 ~ $200,349 ~ ($66,229) ~ $860,650 Services & Supplies Benefits Negotiated salary and benefits adjustments. Add 47 new positions. Two Social Worker Supervisors added midyear Decrease in part-time and temporary staffing. Increase in overtime costs. ~ $80,032 ~ $133,540 Increase in office supplies related to increased staffing. Increase in furniture costs due to increased staffing. G-5

2 ~ $202,806 ~ $63,320 ~ $438,722 ~ ($72,708) Increase in communication costs for high-speed data lines at satellite sites. Increase in equipment maintenance. Increase in computer security software, maintenance, and lease costs. Decrease in copy machine leases based on actual costs. Other Charges ~ $5,001,476 ~ $4,817,008 Increase in CalWORKs payments reflecting a 1.34% caseload growth and increase in cost per case. Increase in Foster Care program costs due to a 8.06% caseload growth and a 2.8% statutory costof-living adjustment (COLA): ~ $258,533 ) ~ $611,312 ~ $588,128 ~ $127,208 ~ $500,000 Increase In mileage reimbursement, client bus passes, and fees based on usage. Increase in professional and contracted support services. Increase in CalWORKs programrelated contract services. Increase In Court-ordered counseling. Increase in child care costs related to CalWORKs program. ~ $1,583,435 ~ ($228,273) ~ $867,157 Increase In Adoption Assistance costs due to a 3.72% caseload growth and a statutory 2.8% COLA. Decrease in General Assistance payments due to a 5% decline in caseloads and a 0.95% decrease in caseload costs. Increase in In-Home Supportive Services program costs due to a 7% restoration of hours and a 3.7% caseload growth. ~ ($106,098) Decrease maintenance costs. Fixed Assets ~ ($242,252) ~ $946,023 Decrease in Workers' Compensation and Casualty insurance costs. Cost Allocation Plan adjustment. ~ $940,000 Furniture for remodeled intake interview and staff development areas. Workload Data* Actual Est./Act. Projected CaIWORKs Assistance 17,104 17,164 16,993 16,887 16,887 Foster Care Foster Home Institutions Foster Family Agencies Adoption Assistance 2,027 1,999 1,982 2,029 2,050 General Assistance 1,622 1,854 1,654 1,580 1,749 In-Home Supportive Services 5,771 5,407 5,531 5,245 5,517 Refugee Cash Assistance Temporary Homeless Shelter Medi-Cal 49,234 52,567 64, , ,000 Cal-Fresh 41,763 42,867 43,764 53,276 59,000 *All Workload Data represent average cases per month. G-6

3 Operating Transfers Out ~ ($610,000) Delete transfers to Capital Outlays for tenant improvement project initiated in Expenditure ~ ($232,239) Revenues Reimbursements ~ $9,045,587 Increase in Administration Federal and State reimbursements. ~ $4,999,859 Increase in CalWORKs Assistance Federal and State reimbursements. ~ $3,736,259 Increase in Foster Care Assistance Federal and State reimbursements. ~ $1,230,617 Increase in Adoptions Assistance Federal and State reimbursements. ~ $550,068 Increase in IHSS Federal and State reimbursements. ~ $19,760 Increase in Temporary Homeless Federal and State reimbursements. Program Discussion The recommended budget for the Agency totals $349,036,989, which is an increase of $21,413,883 from Administration. $163,136,135 Increase in reimbursements from other departments for staff time charged to other programs and wraparound services charged to Foster Care. The Administrative budget contains administrative costs for the operation of all Agency programs and totals $163,136,135, which is an increase of $9,378,000 from The increase is primarily due to an increase in salaries and benefits related to the addition of 47 positions, of which 26 are needed to support Medi-Cal program expansion resulting from the implementation of the Affordable Care Act (ACA). Additional costs of $5.7 million are due to negotiated salary and benefits adjustments and operational costs. The 47 additional positions recommended for include the following classifications: ~ Eligibility Worker (24) ~ Eligibility Supervisor (2) ~ Social Worker (11) ~ Social Worker Supervisor (3) ~ Accounting Technician (1) ~ Child Welfare Services Division Chief (1) ~ Contracts Analyst (2) ~ Program Manager (1) ~ HSA Staff Analyst (2) Child Welfare Continuum Affordable Care Act of Care Reform In 2012, through Senate Bill (SB) 1013, the Legislature requested recommendations to reduce the out-of-home care of children in foster care. This effort culminated with the completion of California's Child Welfare Continuum of Care Reform report in January This report was developed with feedback from foster youth, foster families, care providers, policymakers, stakeholders, and child welfare agency staff from across the State. The report describes substantial steps to achieve improvements in child experiences and outcomes. In February 2015, Assembly Bill (AB) 403 was introduced to comprehensively reform placement and treatment options for youth in foster care to follow recommendations from the report. AB 403 addresses these issues by ensuring that families who provide foster care receive targeted training and support so that they are better prepared to support youth living with them. The bill also advances California's longstanding goal to move away from the use of long-term group home care by increasing youth placement in family settings and by transforming existing group home care into places where youth who are not ready to be placed with families can receive short-term, intensive treatment. Successful implementation of this Statewide effort will occur over multiple years and will require the development of critical elements, including increasing the supply of home-based family care and training. The ACA, which became effective January 1,2014, continues to have significant impacts on both workload and the manner in which HSA provides service to Medi-Cal applicants and recipients. Under ACA, there are significant changes and expansions of health coverage programs (Expanded Medi-Cal). For customers with limited income, Medi-Cal is the public health insurance program that provides coverage at low or no cost. Under Expanded Medi-Cal, California expanded access to Medi-Cal so more individuals are eligible. HSA has experienced significant workload increases in response to ACA and the expansion of the Medi-Cal program. In March 2015, the Medi-Cal caseload surpassed 108,000 cases, representing a 24% increase from March During the most recent ACA Open Enrollment period, which began on November 15,2014 and ended on February 15,2015, HSA's call center received more than 13,000 calls and referrals from Covered California for G-7

4 applicants who were screened and determined to be potentially eligible for Medi-Cal. HSA will continue to utilize California Department of Health Care Services grant funds to conduct and fund outreach and enrollment activities designed to reach uninsured San Joaquin County residents and to assist current Medi-Cal beneficiaries with renewal assistance. HSA is organized into five bureaus: Income Maintenance; Child Welfare Services; Employment and Youth Services; Aging and Community Services; and Administrative Services. Income Maintenance Bureau The Income Maintenance Bureau is responsible for determining, issuing, and maintaining the correct and timely Federal and State mandated benefits for the CaIWORKs, CalFresh, Medi-Cal, General Assistance, Foster Care, and Refugee Assistance programs. As a result of ACA, the transition of the Healthy Families Program to the Medi- Cal Program, outreach efforts, and the changes in the State regulations, HSA has experienced significant increases in applications for assistance and continuing caseload maintenance. HSA continues to collaborate with community partners to conduct outreach to the underserved population and to assist with the application and renewal processes. HSA has also conducted outreach to different communities by leveraging the network of Community Centers operated by HSA's Aging and Community Services Bureau. HSA co-locates Eligibility Workers at the Larch Clover, Garden Acres, Kennedy, Northeast, Boggs Tract, and Lodi Community Centers to provide County residents with increased access to the Cal WORKs, CalFresh, and Medi-Cal programs. In collaboration with San Joaquin General Hospital (SJGH), HSA continues to provide enhanced access to the Medi-Cal program for patients of SJGH by providing a Medi-Cal eligibility unit to process Medi-Cal applications for those served at the Hospital. HSA continues to work collaboratively with the Probation Department to enroll newly released individuals and probationers, as a result of AB 109 (2011), in the CalFresh and Expanded Medi-Cal programs by co-locating Eligibility Workers at the assessment center. In addition, with the enactment of AB 720 (2013), HSA is working collaboratively with the Sheriff's Office to enroll pre-sentence inmates and inmates who receive acute inpatient hospital services in Medi-Cal. The recommended budget adds 16 positions (14 Eligibility Workers and 2 Eligibility Supervisors) to address the existing and anticipated workload increase as a result of the implementation of the ACA. The cost associated with these positions will be fully offset by State and Federal funding. Child Welfare Services Bureau The Child Welfare Services (CWS) Bureau is responsible for services that ensure the safety, permanency, and wellbeing of children who have been abused or neglected. The major components of the CWS programs include: Child Abuse Prevention; Emergency Response; Family Preservation; Family Maintenance; Family Reunification; Permanent Placement; Adoption; and Independent Living. Each CWS component requires specific in-person service delivery by social work staff to prevent or remedy neglect or abuse. State law requires CWS agencies.to investigate reports of child maltreatment either immediately (within 24 hours) or within 10 days, based upon the severity ofthe allegations and risk to the child. When CWS receives a report of suspected child abuse or neglect (which is also called a "referral"), CWS social workers investigate the report to determine if the alleged child maltreatment is "substantiated" as defined in State law. Substantiated reports require further action by CWS, and can result in either the provision of supportive services to the child and family or, if there is imminent risk to the child's safety, the removal of the child from the home. Ongoing case management services assist in the development of basic life skills of the family to keep the family intact or to develop alternate family structures when the child cannot safely remain at home. Adoption services provide permanency options for children who are unable to be reunified with their birth families. The Independent Living program provides foster youth with education and other supportive services designed to help transition youth from foster care to living independently. Federal and State law also require CWS social workers to visit foster children on a monthly basis. AB 12 (2010) was intended to improve the outcomes for youth in foster care by extending assistance to eligible youth who remain in foster care up to the age of 21. CWS is heavily impacted by court and regulatory changes. Recent events in these areas have included mandated screening and assessment of all foster children for mental health services as a result of a court settlement known as "Katie A." Regulatory effects have been seen in the areas of monthly foster child in-person visit standards, which have been raised from 90% to 95% as of October 1, On August 1,2015, all California counties will be required to have implemented a Federal case review process through which Continuous Quality Improvement efforts will be measured. In the practice area, HSA has adopted Team Decision Making and Safety Organized Practice, as family engagement strategies designed to actively incorporate the immediate and extended family in reunification efforts. The recommended budget includes eight new positions (six Social Workers, a Social Worker Supervisor, and a Child Welfare Services Division Chief) to address G-8

5 increased workload demand related to programmatic enhancements and regulatory changes. The cost associated with these positions will be fully offset by State and Federal funding. Employment & Youth Services Bureau The Employment and Youth Services Bureau provides employment, education, and training services under the CalWORKs program. Federal and State assistance available to Cal WORKs participants is subject to time-limits of no more than two years for able bodied adults, with stringent requirements for participation in Welfare-to- Work (WTW) activities leading to self-sufficiency. Participation includes job preparation and placement services, work experience, employment activities, vocational training and education, mental health and substance abuse treatment, and community services. The WTW program provides 24 months of flexibility for CalWORKs clients to receive a wide array of services and supports to enter and remain in the workforce. Participants may be eligible to assistance beyond 24 months if they meet specific criteria, including meeting the Federal Work Participation Rate or have a qualifying exemption. The Family Stabilization (FS) component of the Cal- WORKs program provides intensive case management and services to clients who meet the criteria set forth in AB 74 (2013). FS is designed to ensure a basic level of stability within a family prior to, or concurrently with, participation in WTW activities. The goal of FS is to increase client success in light of the flexible WTW 24-Month Clock through more intensive case management and the assignment of clients to the additional activities or barrier removal services necessary to ultimately achieve self-sufficiency. Cal WORKs recipients are eligible to participate in FS if a county determines that a family is experiencing an identified situation and/or crisis that is destabilizing the family and would interfere with adult clients' ability to participate in WTW activities and services. Subsidized employment has been as a critical path to selfsufficiency for Cal WORKs clients in the County. AB 74 (2013) created the Expanded Subsidized Employment (ESE) Program in California thereby further emphasizing subsidized employment as a Statewide strategy to transition participants to the workforce. HSA has long-standing partnerships with the Greater Stockton Chamber of Commerce (Chamber) and Employment and Economic Development Department (EEDD) to provide a subsidized employment program, known as the Stockton Chamber Apprentice Program-Subsidized Employment (SCAP-SE), for CalWORKs participants. This partnership has developed successful strategies to link clients with employers, including robust employer outreach and recruitment, job development, employer screening, job matching, and ultimately job placement. Under SCAP-SE, the Chamber identifies potential job openings in the area and works with the case managers to place Cal WORKs participants with the appropriate employers. Employers who hire Cal- WORKs participants through SCAP-SE may be reimbursed for up to 50% of the wages paid for up to six months. The employer is expected to retain the participant upon successful completion of SCAP-SE. HSA will continue to partner with EEDD's WorkNet to offer low-income youth in San Joaquin County opportunity to participate in the Summer Youth Employment and Training Program (SYETP). This ongoing program has provided thousands of young people in San Joaquin County with the opportunity to earn a paycheck while learning lifelong.skills and providing services to their community. SYETP provides up to 1,000 youth between the ages of 14 and 21 the opportunity to gain meaningful work experience and develop the skills, attitudes, and commitment necessary to succeed in today's work world. The recommended budget adds two Contracts Analyst positions to enhance HSA's programmatic and fiscal monitoring efforts. The cost associated with these positions will be fully offset by State and Federal funding. Adult & Community Services Bureau The Adult and Community Services Bureau provides mandated services to abused, neglected, exploited, and/or disabled adults to prevent or reduce inappropriate institutional care when no other form of care is appropriate, and to help individuals achieve and maintain the highest level of independence, self-support, and self-sufficiency within their range and scope of their capabilities. Mandated services for adults include: Information and Referral, IHSS, and Adult Protective Services. The implementation of ACA and resulting increase of clients receiving Medi-Cal has impacted the IHSS program. IHSS helps pay for services provided to elderly and disabled persons so that they are able to remain in their home. To be eligible, clients must be over 65 years of age, or disabled, or blind, and meet income and resources limits for the program. IHSS is considered an alternative to out-ofhome care, such as nursing homes or board and care facilities. ACA has increased the number of eligible Medi-Cal clients, which results in a larger eligible population for IHSS. IHSS has experienced an 8.8% growth in program applications over the prior year. In July 2012, the State implemented ACA and a pilot program of the Coordinated Care Initiative (CCI) in eight counties (San Mateo, Los Angeles, Riverside, San Bernardino, San Diego, Santa Clara, Orange, and Alameda), to begin after March 1,2013. The CCI pilot is intended to provide home and community-based services for individuals who are "dual-eligible" for Medi-Cal and Medicare, and managed through a county Medi-Cal Managed Care t G-9

6 Plan. The implementation of CCI also made two additional changes. First, it created a county Maintenance-of- Effort (MOE) in lieu of the previous sharing ratio methodology, and second, it intended to transition collective bargaining for IHSS providers from local Public Authorities to a Statewide Public Authority. Due to various Statewide delays, Alameda County opted out of the CCI pilot. The State has plans to evaluate the opt-out rate (69% by eligible clients) in January 2016, and is proceeding with San Mateo County to transition to a Statewide Public Authority. To address the increased workload associated with additional program applications and regulatory requirements, the recommended budget includes seven new positions (five Social Workers and two Social Worker Supervisors). The cost associated with these positions will be fully offset by State and Federal funding. Administrative Services Bureau The Administrative Services Bureau provides support services throughout the Agency and includes the following functional areas: Policies and Procedures; Staff Development and Training; Information Systems; Fiscal and Accounting; Quality Control; Fair Hearings; Benefit Recovery; Collections; Personnel; Reception and Benefit Issuance; and Staff Support. HSA Staff Development and Training staff develops training curriculum and delivers comprehensive instruction to HSA staff, with primary focus on the CaIWORKs, Cal Fresh, and Medi-Cal programs and the C-IV automated welfare system. In an effort to meet the demands of the complex programs administered by HSA, Eligibility Workers must complete a comprehensive training course. Historically, the induction training course has consisted of 12 weeks of classroom instruction and four weeks of case processing instruction. HSA is working with the General Services Department to develop HSA's new Staff Development Training Center in the County Administration Building. It is anticipated that the new Training Center will be completed in the fall of 2015 and will allow the Eligibility Worker training course to expand to 14 weeks of classroom instruction and 14 weeks of case processing instruction. This new training center, consisting of approximately 8,700 square feet, will include two large specialized classrooms with a capacity of28 each, one classroom with a capacity of 12, and office space for the training staff. The expanded induction training will provide new Eligibility Workers with a greater foundation in complex HSA programs through expanded hands-on training and an enhanced level of supervision. The recommended budget adds 14 positions (1 Program Manager, 2 HSA Staff Analysts, 10 Eligibility Workers, and 1 Accounting Technician). The Program Manager, Staff Analyst, and Eligibility Worker positions are needed to support the expanded Eligibility Worker induction training model designed to better prepare trainees for the demands of the complex assistance program administered by HSA. The cost of these positions will be fully offset by State and Federal funding. The following are changes projected for the various assistance programs administered by HSA: CalWORKs Assistance - $98,304,545 The CalWORKs program is the largest cash assistance program for children and families, providing financial help to families to meet basic needs (shelter, food, and clothing) when they are unable to meet those needs on their own. The CalWORKs program represents a welfare system based upon principles that place high value on recipients obtaining work. Eligible families must include a child under age 18, who lacks parental care and support due to absence, death, incapacity, or the unemployment of one or both parents. CalWORKs Assistance is time limited for most adults in the household and most recipients are required to work or participate in WTW activities for a minimum number of hours per week. The necessary supportive services, including child care, are provided to ensure employment is possible. The amount of a family's monthly assistance payment depends on a number of factors, including the number of people who are eligible and the special needs of any of those family members. The income of the family is considered in calculating the amount of cash aid the family receives. The recommended budget includes an increase of $5,001,476 from This increase is the result ofa 1.34% increase in estimated caseloads based upon current trends and programmatic changes, and a 3.97% increase in the cost per case based on the net result of a 5% Maximum Aid Payment increase that became effective April I, 2015, and a 1.03% decrease based upon actual experience. Programmatic changes that have limited caseload growth include the gradual reengagement of individuals previously exempt from WTW activities under the short-term young child exemptions and the continued effects from the restructuring of the CalWORKs program that created a prospective 24-month time limit on cash assistance and employment services for adults, and provides an additional 24 months to adults who meet Federal work requirements or other Federally allowable activities. Other factors potentially affecting caseloads are the Expanded Subsidized Employment program (ESE) and the creation of the Family Stabilization program. The ESE program is one part of Early Engagement strategies being implemented as a result of the passage of AB 74 (2013). In addition to wage and non-wage costs for the job placements, ESE funds may be used to cover all operational costs of the ESE program, including the cost of overseeing G-10

7 the program, developing work sites, and providing training to participants. The Family Stabilization program is a component of the CalWORKs program that provides intensive case management and services to address immediate crisis situations and needs. Effective January 1,2014, CalWORKs recipients became eligible to participate in family stabilization if the County determines that a family is experiencing an identified situation or crisis that is destabilizing the family and would interfere with participation in WTW activities and services. Foster Care - $42,682,185 The Foster Care program provides support payments for children in out-of-home care. This program is administered by the counties in accordance with regulations, standards, and procedures set by California Department of Social Services (CDSS) as authorized by law. The Out-of- Home Care System is designed to protect those children who cannot safely remain with family. Most are removed from their parents and made dependents of the court. A smaller number are wards of Juvenile Probation or live with legal guardians. Some are voluntarily placed in outof-home care by their parents. Currently, these children are placed in family homes with relatives, in licensed foster family homes, in homes certified by foster family agencies, and in group homes. Statutorily, relatives are given preference over other types of placements. All providers for these children, except relatives not participating in the Approved Relative Caregiver Funding Option (ARCO) program and legal guardians, are studied and licensed to provide care. A written case plan is developed for each child and family to ensure care and protection consistent with the best interests and special needs of the child. The plan includes a judicial or administrative review every six months to determine if out-of-home care is still required. As children in the program begin to mature, independent living training and services are made available to teens beginning at age 16 and continuing up until age 24 to provide job and career development skills that will be needed to live independently. AB 12 (2010) extends foster care benefits to youth through age 21. To be eligible to receive extended foster care benefits, youth must be in foster care prior to age 18. When a child is removed from the physical custody of a parent, Federal and State laws require that preferential consideration be given to placing the child with a relative. Although placement with a relative is preferred, the funding available for placement is dependent upon whether the child is considered Federally eligible or non- Federally eligible. Children who, at the time of removal from the home, would have been eligible for Aid to Families with Dependent Children (AFDC) assistance based upon rules in place in 1996 are considered Federally eligible and may receive a Foster Care assistance payment. Children who would not have been eligible for AFDC at the time of removal are considered non-federal and may be eligible for a lower CalWORKs assistance payment. On June 20, 2014, the Governor signed SB 855 establishing the ARCO program. This program, beginning January 1,2015, was established to increase permanency outcomes by making the amount paid to an approved relative caring for a dependent child the same regardless of the child's eligibility to Federal Foster Care. The ARCO program is fully reimbursed with State funds. The recommended budget reflects an increase of $4,817,008 from The increase is due to an 8.06% increase related to higher cost placement types, a statutory 2.8% cost-of-living adjustment for children in foster family home and group home placements effective July 1, 2015, and a 1.8% increase related to the implementation of the ARCO program. Adoptions Assistance - $23,060,579 The Adoptions Assistance Program (AAP) was developed to encourage the adoption of special needs children and remove the financial disincentives for families to adopt. If the child is deemed eligible, an adoption assistance agreement or a deferred adoption assistance agreement is executed with the adoptive parents prior to the adoption finalization. A reassessment of the child's needs 'and family's circumstances is conducted every two years. The amount of financial assistance is determined based upon the special needs of the child and circumstances of the family. AB 12 (2010) extended AAP benefits beyond the age of 18 for eligible youth when the youth was adopted at age 16 or later. The intent of the extended AAP benefit is to help youth maintain a safety net as they transition to independence. The recommended budget includes an increase of $1,583,435 from This reflects an anticipated caseload increase of 3.72% based upon actual experience and a statutory cost-of-living increase of 2.8% effective July 1,2015. General Assistance - $3,606,667 The General Assistance (GA) program provides relief and support to indigent adults who are not supported by their own means, other public funds, or other assistance programs. California Welfare and Institutions Code Section requires counties to administer a GA program. The authority to define and develop the GA program is delegated to each County Board of Supervisors. G-11

8 Participants repay GA payments by working a specified number of hours each month in the GA Work Program. Repayments may also be made by collecting proceeds from the sale of real property, withholding an amount equal to the GA interim assistance payments from a lump sum Social Security award, or collecting from the recipient's sponsor. The GA program is funded 100% by the County. The rec" ommended budget includes a decrease of $228,273 from The decrease reflects an estimated 5% caseload decrease due to continued caseload stabilization of released prisoners associated with AB 109 (2011) Public Safety Realignment and a projected 0.95% cost per case decrease. In-Home Supportive Services - $17,425,278 The IHSS program provides specified supportive services to enable eligible persons to remain in their own homes as an alternative to out-of-home care, such as nursing homes or board and care facilities. Eligible persons are aged, blind, or disabled recipients of public assistance and similar persons with low incomes. Disabled children are also eligible for IHSS. Services include: domestic services and other related services such as meal preparation, laundry, shopping and errands; personal care services; assistance while traveling to medical appointments or to other sources of supportive services; protective supervision; teaching and demonstration directed at reducing the need for supportive services; and certain paramedical services ordered by a physician. In , the CDSS changed the local financial obligation for the IHSS program from a percentage-based payment structure to a MOE. The IHSS MOE includes the County's required match for negotiated salary and benefit costs for IHSS providers and operational costs for the IHSS Public Authority. The recommended budget includes an increase of 867,157 from , which reflects a 7% restoration of hours and a 3.7% Statewide estimated caseload increase based on the Governor's January Proposed Budget. Temporary Homeless Shelter - $741,600 Families who are eligible for CalWORKs and are homeless may apply for a special need payment to meet costs for temporary and permanent housing. The maximum homeless assistance payment is based on the size of Cal- WORKs family. Homeless Assistance is available only once-in-a-lifetime unless the family is homeless due to domestic violence, natural disaster, uninhabitability, or a physical or mental disability. All exceptions must be verified by a third-party agency. CalWORKs families may be eligible to apply for homeless assistance benefits to assist with the payment of rent arrearages. Payment of arrearages is considered a family's once-in-a-lifetime Homeless Assistance payment. Th~ recommended budget reflects an increase of $5,080 from The increase is related to the net result of an estimated 3.9% caseload increase and a 3.09% cost per case decrease based on actual experience. Refugee Cash Assistance - $80,000 Refugee Cash Assistance provides up to eight months of cash assistance to needy refugees without children who are.' not otherwise eligible for other cash aid. These refugees are unable to return to their country of origin because of persecution or a well-founded fear of persecution on account of race, religion, nationality, or political opinion. These individuals may also be eligible to receive employment and other. social services during the same eightmonth period. Funding of the Refugee Cash Assistance Program is 100% Federally-reimbursed. G-12