The state’s fastest growing major social service program is not a cost-effective approach to keeping elderly and disabled people out of nursing homes, according to a report issued today by the Legislative Analyst’s Office. The LAO examined a long-held but rarely questioned assumption: that the In-home Supportive Services program, which provides assistance with bathing, cooking, and other household tasks, is a bargain for the state despite its rapidly rising costs because without it, most of the people who receive the services would be moved into institutional care. The researchers created a model showing that for the program to be a fiscal win for the state and county government combined, you have to assume that at least 58 percent of the recipients who are not developmentally disabled would go into nursing homes in the absence of their in-home services. And the LAO concluded that this would not happen. The office did say that from strictly a state perspective, ignoring the counties’ share of the costs, the program might be cost-effective. And the report noted that IHSS has other goals as well, including improving the quality of life of the recipients and their families, that might make it worthwhile even if it is not saving the taxpayers money. See the full report here.