DHCS recently clarified the process for using out-of-pocket expenses from personal care services to meet current or future share of cost amounts. Previously, IHSS needed to assess and approve the need for personal care services, and the out-of-pocket costs of approved hours were used as an income deduction. Since these services are now provided as a Medi-Cal benefit, out-of-pocket costs can now be used to meet share of cost and not income deductions.
These out-of-pocket personal care services must be prescribed by a healthcare professional. The services need not be assessed by IHSS or provided by an IHSS provider, and they may exceed the maximum assessed IHSS hours as long as the need for hours has been documented.
The letter provides answers to frequently asked questions about using these out-of-pocket expenses toward the Medi-Cal share of cost. DHCS ACWDL 15-02 (1/12/15).