IHSS Quality Improvement Action Plans for noncompliance with timely application processing, recertifications and Hourly Task Guidelines

The California Department of Social Services (CDSS) has issued a letter reiterating IHSS requirements for timely processing of applications and reassessments, and for following Hourly Task Guidelines.

Individuals have the right to apply for IHSS services.  When an individual or their authorized representative indicates that they want to apply, the county must take their application immediately.  Counties must accept applications by telephone, fax or in person.  Counties that have the capability must accept applications online, by email or through other electronic means.

The date the applicant requests services is the “protected date of eligibility” even if the client has not already applied for Medi-Cal.

The applicant must submit the SOC 873 Health Certification form, or other acceptable documentation, within 45 days of the date the county requests it.  Benefits can be issued prior to the applicant submitting a SOC 873 when the applicant is at imminent risk of out-of-home placement, or the applicant is being discharged from a hospital or nursing home and services are needed to safely return to the community.  Applicants who receive benefits pending submitting the SOC 873 can get an additional 45 days to submit the SOC 873 for good cause.  In addition, applicants who have not yet applied for Medi-Cal can have 90 days to submit the SOC 873 because there is 45 days to determine Medi-Cal eligibility.

Reassessments must be done every 12 months.  CDSS requires counties to complete reassessments timely in 80 percent of cases.  Counties must complete reassessments time in 100 percent of Community First Choice Options cases, CDSS will find noncompliance if the county complete assessments timely in 90 percent of Community First Choice Options cases.  Counties will be required to submit a Quality Improvement Action Plan if they do not meet these requirements.

Counties must use the Hourly Task Guidelines for initial assessments or reassessments.  These guidelines establish a range of time for each IHSS service.  The county must document the need to services that fall outside the Hourly Task Guidelines.  Beginning in fiscal year 2023-24, CDSS will require a Quality Improvement Action Plan for counties that do not correctly apply and document applying Hourly Task Guidelines.  (ACL 22-57, July 22, 2022.)