HHS Approves $1.7 Billion, Five-Year Federal Medicaid Waiver for In-Home Supportive Services Program

California will receive an additional $1.7 billion in federal Medicaid funds over the next five years to help pay for the In-Home Supportive Services Program, which allows low-income elderly and disabled residents to hire their own caregivers, under a federal waiver HHS Secretary Tommy Thompson announced Thursday, the Sacramento Bee reports (Benson, Sacramento Bee, 8/13). Gov. Arnold Schwarzenegger (R) in January had proposed reducing the program's budget by one-third, but after a "huge public outcry" during state budget negotiations, he "pledged to restore the program" with the aid of federal funds, the San Jose Mercury News reports. Schwarzenegger's July budget assumed that the Bush administration would grant the waiver for IHSS.

Thompson said the waiver will provide the program's 66,000 participants with about $340 million annually in federal funds (Feder Ostrov, San Jose Mercury News, 8/13). The waiver is the largest ever granted by Thompson and President Bush under the Independence Plus program, which is intended to help people live outside of nursing homes or institutions (HHS release, 8/12). The state and counties had been fully responsible for funding the program because federal rules do not allow federal funds to be used for payments to relatives. The Medicaid waiver bypasses those rules, although the state and counties still must contribute funds to the program. The federal government also is allowing other states that have similar programs modeled on IHSS to pay relatives for home care.

Health and Human Services Agency Secretary Kimberly Belshe said the waiver recognizes "that care provided by family members is equal to that of those who are hired professionals."

Thompson said, "President Bush and I believe that whenever possible, people should live at home rather than in an institution, and that's exactly the same philosophy that Governor Schwarzenegger has. So we're delighted to allow these Californians to continue living at home."

Frank Mecca, director of the County Welfare Directors Association of California, said he "commend[ed] the governor for really aggressively pursuing a really good waiver" (Sacramento Bee, 8/13). Mecca added that the waiver "really does take the pressure off and reduces the anxiety of people who depend on the program. It didn't hurt having a president with a very good relationship to the governor, but it wasn't a slam dunk" (San Jose Mercury News, 8/13).