Author: Stephen Goldberg

Extraordinary circumstances exception to IHSS provider workweek and travel time limitations

Posted on by

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).

Violations for exceeding IHSS provider workweek and travel time limitations

Posted on by

The California Department of Social Services has issued instructions about violations for IHSS providers who exceed workweek and travel time limitations.  Those limitations are described in ACL 16-01.

A violation of the workweek and travel time limitations occurs when: 1) a provider works more than 40 hours in a workweek without county approval and the recipient’s receives less than 40 hours; 2) a provider works more hours in a workweek than the recipient’s maximum weekly hours causing the provider to work more overtime hours in a month than normal without county approval; 3) a provider works more than 66 hours in a week when working for multiple recipients and 4) a provider claims more than 7 hours of travel in a workweek.

The first violation causes a written warning.  The second violation is a warning and a one-time opportunity to complete voluntary instructional materials.  If the materials are completed within 14 days, the second violation is rescinded.  The next violation would then be considered the second violation and will not be rescinded.  The materials are attached to ACL 16-44.

The third violation causes a 90 day suspension of the IHSS provider’s eligibility to work.  The fourth violation causes a one year suspension of the IHSS provider’s eligibility to work.

If a provider has no violations for a year, one violation is rescinded.

For first and second violations, providers can request a county administrative review of the violation, followed by an administrative hearing.  For third and fourth violation, providers can request a county administrative review, then a CDSS administrative review, then an administrative hearing.  ACL 16-36 (April 21, 2016).

Submission of IHSS Provider Enrollment Agreement

Posted on by

The California Department of Social Services previously stated in ACL 16-01 that In Home Supportive Services providers were required to submit the Provider Enrollment Agreement (SOC 846) by April 15, 2016 or be terminated on May 1, 2016.

CDSS changed its policy so that providers who did not submit the SOC 846 by April 15, 2016 will not be automatically terminated.  The SOC 846 remains a required form that must be submitted and counties must assist in providers in completing the form.  ACL 16-27 (April 14, 2016).

WTW requirements for Pregnant Woman Only Assistance Units

Posted on by

The California Department of Social Services has issued instructions about Welfare-to-Work (WTW) requirements for Pregnant Woman Only (PWO) Assistance Units. Pregnant women with no other eligible children in the home are now eligible for CalWORKs beginning in the second trimester of pregnancy.

Unless exempt from WTW, PWOs must participate for 20 hours per week to meet minimum participation requirements because they are considered a household with a child under age 6.  However, to meet federal participation requirements, PWOs must participate 30 hours per week, 20 hours of which much be in a federally approved activity.  If a PWO meets the 20 hours per week minimum but not the 30 hours per week federal requirement, the PWO’s 24 month clock ticks. ACL 16-21 (April 15, 2016).

CAPI eligibility for citizens of free associated states

Posted on by

The California Department of Social Services has issued a clarification that citizens of the free associated states of the Marshall Islands, Micronesia Palau are eligible for the Cash Assistance Program for Immigrants (CAPI).

Persons are eligible for CAPI if they are lawful immigrants who would have been eligible for Supplemental Security Income (SSI) benefits before August 22, 1996, the day the federal welfare reform law became effective.  Lawful immigrants who were eligible for SSI before August 22, 1996 include persons who qualify as Persons Residing Under Color Of Law (PRUCOL).

Citizens of the freely associated states are PRUCOL and are therefore eligible for CAPI.  ACL 16-33 (May 2, 2016).

Misconduct and unemployment insurance ALJ duty to develop the record

Posted on by

The California Unemployment Insurance Appeals Board (CUIAB) has issued P-B-510 which holds that due process requires the Administrative Law Judge (ALJ) to develop the record in an unemployment insurance hearing.  The case involves termination for tardiness based on an employer’s no fault attendance policy.  The decision first holds that an employer’s attendance policy has no bearing on eligibility for unemployment insurance, and whether an employee has committed misconduct is based on unemployment insurance law and the particular facts of the case and not on the employer’s attendance policy.

The decision continues that, in attendance cases, the final incident must be analyzed to determine if it is misconduct, and that is done by examining whether the incident breached an important duty to the employer and injured or tended to injure the employers interest.  If so, the employee must show good cause.  If there is not good cause, the employee will have committed misconduct if the final incident was substantially detrimental to the employer’s interest or the employee had at least one prior justified warning for a similar incident.

The CUIAB then found that the ALJ had to a duty to develop “a comprehensive evidentiary record” surrounding the final incident, including the reason for the tardiness, the reasons the employee did not provide notice of the tardiness, the impact on the employer and the facts surrounding prior attendance issues and reprimands.  The ALJ failed to develop the record, and that failure justified remand for a new hearing to fully develop the record.  P-B-510 (February 24, 2016).