IHSS backup provider system

The California Department of Social Services (CDSS) has established a permanent Back-Up Provider System (BUPS) for the In-Home Supportive Services (IHSS) and the Waiver Personal Care Services (WPCS).

The permanent BUPS allows any eligible IHSS recipient to receive temporary IHSS or WPCS from a backup provider. This is available when the recipient has an urgent need for backup related to personal care services that cannot be met by an existing provider, or the recipient is transitioning to home-based care and does not yet have an identified provider. For BUPS to be available, the need must be immediate and cannot wait until the provider is available to provide the need, and the need has a direct impact on the IHSS recipient, and delaying it would potentially jeopardize the health/safety of the IHSS recipient which may result in the need for emergency services and/or out-of-home placement.

The Back-Up Provider System provides eligible recipients with a maximum total of 80 hours per fiscal year (July 1 to June 30) and will reset to 80 hours on July 1 of each year. There are exceptions to the 80-hour annual limit, granted on an as-needed basis for severely impaired recipients. The exceptions cannot exceed 160 hours per fiscal year. These exceptions may only be granted if the funding for the exception is appropriated in the annual State Budget Act.

Counties shall work with recipients who are transitioning to home-based care and, requesting backup services to consider the following when determining if a backup provider is appropriate for that individual: how much urgent care the recipient would need upon transition and whether the use of BUPS is appropriate and safe for the situation being requested, whether or not the recipient would have difficulty managing a provider from the BUPS, and that a BUPS provider can only provide services temporarily and they may also need the direct support of friends and/or family until they hire permanent provider.

Counties should try to assist recipients in obtaining a backup provider whenever possible. Examples of when a backup provider would be appropriate and safe to use the BUPS while transitioning to home care may include: a newly approved recipient who is being released from the hospital and has the support system of family/friends and a family member who will be designated authorized representative to manage the BUPS provider during the time the permanent provider is being located; and an existing recipient who has an extended hospital stay, no longer has a permanent provider and has an urgent need for services.

For recipients with two or more regular providers, if the recipient has the need to use the BUPS. An exception from the provider workweek limitations may be authorized for one of the regular providers. The recipient may assign the hours to their other provider without requiring county approval so long as the hours worked by the single provider do not exceed the maximum weekly hours, or, if the provider works for more than one recipient, does not cause them to exceed 66 hours in a workweek.

The recipients are allowed to hire, terminate, and supervise the backup provider. However, if they choose to not use or terminate the backup provider referred by the county or public authority, it is their responsibility to find and hire a backup provider. Any provider they choose that is not part of BUPS, will not be paid the two-dollar salary differential. Moreover, the chosen provider must be eligible and enrolled within the IHSS program in the county the recipient resides.

In order to be eligible to serve as a backup IHSS/WPCS provider the provider must not have been convicted of any crime in Tier 1 and 2 within the previous ten years. However, a provider with a Tier 2 criminal conviction is permitted to work for a recipient that has submitted an Individual Waiver. Waivers cannot be used for providers in the BUPS. The provider must meet all requirements of provider enrollment including the submission of provider enrollment. An individual who is listed on the county and Public Authority registry but has yet to complete all enrollment requirements to serve as an IHSS provider cannot be included on the BUPS registry.

All eligible providers who provide emergency backup services shall be paid a wage that is two dollars per hour above the current county/public authority locally negotiated wage rate for an IHSS/WPCS provider, subject to an appropriation in the annual State Budget Act. Additionally, the current two-dollar salary differential for the emergency backup providers related to COVID-19 will continue through September 30, 2022.

When operating the BUPS, county and public authorities shall be responsible for making reasonable efforts to recruit and enroll any available provider if possible, responding to recipient requests for an emergency backup provider, and referring recipients to one or more backup providers, if available and align with the recipients preferences and needs. (ACL 22-65, August 2, 2022.)