The California Department of Social Services has issued clarification regarding several In Home Supportive Services (IHSS) Protective Supervision (PS) issues.
When two or more IHSS recipients are living together and receiving PS, the need is considered a common need and is prorated between the recipients. CDSS issued instructions for how to prorate PS in the CMIPS II computer system.
Alternative resources are supportive services that are available to meet the recipient’s needs. The county shall arrange for delivery of alternative services when they are available at no cost to either the IHSS program or the recipient. Examples of alternative resources include adult or child day care centers, schools, community resource centers, Senior Centers and respite centers. Multipurpose Senior Services Program and Regional Centers cannot be considered alternative resources. Voluntary services cannot be considered an alternative resource, but can be used to fulfill the recipient’s 24 hour per day plan.
Environmental modification cannot be required to eliminate the need for PS. However, existing environmental modifications can be considered if they eliminate the safety hazard that puts the recipient at risk. Modifications or restraints such as locking the recipient in a room cannot be considered an appropriate modification.
The risk of falling can be considered for PS if the reason for the fall risk is related to the recipient’s mental impairment or illness. For example, PS can be authorized for a recipient who has a fall risk if the recipient is unable to walk unassisted but, due to a mental impairment, forgets and frequently attempts to walk unassisted.
Eligibility for PS because of combative behavior is based upon evaluation of the willfulness of that behavior. The recipient is considered nonself-directing if they are unable to assess the danger and risk of self harm. An example is head banging as a manifestation of mental impairment or illness. A recipient who displays intentional self-destructive behavior with the knowledge that the behavior may cause self harm would not be eligible for PS. Recipients who exhibit anti-social or aggressive behavior directed to harm other people are ineligible for PS. (ACL 17-95, September 12, 2017.)