Mendocino County's Department of Social Services is grappling with a significant funding gap for its In-Home Supportive Services (IHSS) program, which provides crucial care for the elderly and disabled, according to a letter sent by the county director of social services to the chairs of the state senate and assembly budget committees last month.
In the letter, DeNeese Parker, director of the Department for Social Services, asks the state to update its budget methodology to increase Mendocino County’s allocation for administrative work to address the growing strain on the program.
Mendocino County received $2,187,280 in state funding in 2023 and $2,187,330 in 2024, an increase of just $50, according to information provided by the Department for Social Services.
The IHSS program aims to support recipients in remaining safely and independently in their homes by providing services such as domestic support and personal care. However, a 34% increase in caseloads since 2017, rising from 1,708 cases to 2,303 as of last month, coupled with a surge in annual applications from 883 in 2017 to 1,125 in 2024, has stretched the existing resources thin.
Natasha Adams, a senior program manager for social services in Mendocino County, explained that the increase in caseloads is due to the aging population and expansions in eligibility for the program, including the Affordable Care Act and, more recently, the state's medical expansion for undocumented individuals.
In 2024, Mendocino County’s case load increased 15%, up from 2002 in 2023. But applications dipped, falling five percent from 928 in 2023. Meanwhile, the number of social workers has fallen from 13 in 2023 to 11 in 2024.
California expanded Medi-Cal coverage to all low-income residents aged 26-49, including people without legal status in the United States, on January 1, 2025. Previously, California had expanded Medi-Cal to undocumented children in 2016. Young adults between 19 and 25 were added to the program in 2019. And in 2022, adults 50 and older became eligible for full-scope Medi-Cal, regardless of legal status.
California is one of six states that provide fully funded health care to low-income adults, regardless of whether they are in the country legally. According to CalMatters, there are 1.6 million people without legal status enrolled in Medi-Cal.
The expansion has cost California more than anticipated, forcing the state to borrow $3.4 billion from the state’s general fund. In total, California is spending $8.4 billion on health care for people who have no legal status in the United States.
The expansion has cost California more than anticipated, forcing the state to borrow $3.4 billion from the state’s general fund. In total, California is spending $8.4 billion on health care for people who have no legal status in the United States.
The expansion, which includes in-home supportive services, has had ripple effects on counties. In 2024, Mendocino County’s case load increased 15%, up from 2002 in 2023. But applications dipped, falling five percent from 928 in 2023. Meanwhile, the number of social workers has fallen from 13 in 2023 to 11 in 2024.
Social workers conduct one- to two-hour in-home assessments for every applicant and provide annual assessments to individuals receiving care.Their workload includes processing and tracking all applicant forms, as well as denials. For eligible individuals, social workers assist them in identifying a provider and ensuring the provider is paid. The county currently has approximately 1,900 IHSS providers, but faces a constant need for more, particularly in rural areas and for those requiring personal care. Family members are eligible to be paid as providers.
Without adequate staffing, the county faces challenges in conducting timely assessments and authorizing services, leading to a current backlog of 688 re-assessments and potentially impacting the quality of care.
The letter also notes that without additional resources, the county will be unable to adequately support the rising caseload of IHSS recipients, potentially compromising the program's ability to ensure Californians can live independently and with dignity.
The audio version of this story originally aired on April 8, 2025.
