County grapples with soaring costs of vital IHSS program

In a recent government meeting, officials discussed the financial implications of the In-Home Supportive Services (IHSS) program, which has become the largest single program in the county's budget. For the fiscal year 2023-2024, the county's total budget is projected at $4.8 billion, with $87 million allocated specifically for IHSS. However, when considering off-budget amounts, the total budget for IHSS could reach approximately $778 million, accounting for 14% of the overall county budget.

Concerns were raised regarding the rapid growth of the IHSS program, which has seen an annual increase in costs, largely driven by Medi-Cal expansion. Projections indicate that the program could experience an 11% increase in the upcoming year, following a 9% rise in the previous year. This growth raises questions about the county's ability to sustain its share of costs, which currently stands at 16%, while the state and federal governments cover 30% and over 50%, respectively.

Officials highlighted the potential risks if state or federal funding commitments were to wane, as the county may struggle to absorb additional financial burdens. The IHSS program currently employs over 25,000 providers in Fresno County, underscoring its significance in supporting individuals with disabilities and the elderly.

The discussion also touched on wage increases for IHSS providers, noting that federal and state regulations limit how much counties can pay. Currently, the county has opted to exceed the minimum wage by $1.45, but any further increases could lead to substantial financial implications, with estimates suggesting that a $1 wage increase could cost the county an additional $6 million.

As the meeting concluded, officials acknowledged the critical nature of the IHSS program while expressing concerns about its sustainability amid rising costs and regulatory constraints. The future of the program remains uncertain, particularly in light of ongoing discussions about Medi-Cal expansion and funding commitments from higher levels of government.