The California Department of Social Services has issued instructions about the extraordinary circumstances exception to IHSS provider workweek and travel time limitations. The extraordinary circumstances exception is available to providers who work for two or more recipients and the recipients meet at least one of the following: 1) have complex medical and/or behavioral needs that must be met by a provider who lives in the same home as the recipient; 2) live in a rural or remote area where providers are limited and as a result the recipient cannot hire another provider or 3) is unable to hire a provider who speaks their language in order to direct their care.
The complex medical or behavioral needs exception applies only when the recipient’s physical or mental health would be harmed to the point of risking out of home placement if services are provided by anyone other than the primary IHSS provider. Counties will review this exception every 12 months.
The rural or remote location exception applies to areas that are outside of urban areas, defined as population over 50,000 people and outside of urban clusters, which is defined as population centers of between 2,500 and 50,000 people. The county is required to search for alternative providers, and must review this exception every six months.
The language barrier exception only applies when the inability to hire a provider who speaks the recipients language results in a consistent barrier to the recipient directing their own care that cannot be overcome. CDSS states that tasks that do not require direction by the recipient such as domestic or related services or some personal care services which only require some direction from the recipient, can be performed by a provider who does not speak the recipient’s language. The county is required to search for alternative providers, and must review this exception every six months.
CDSS also clarified the live-in family care provider exception. This exception can apply people who were live-in care providers before January 31, 2016 if the exception is needed after that date because of a change in the recipient’s condition. ACL 16-22 (April 1, 2016).