ITIN and SSN requirements for IHSS applicants and recipients

The California Department of Social Services (CDSS) has issued instructions about In Home Supportive Services (IHSS) recipients as employers of their providers.  The IHSS recipient is an employer of record of the provider.  CDSS performs payroll and other functions for the IHSS recipient. For CDSS to complete these functions, all IHSS recipient and applicants must have a Social Security Number (SSN).  If the applicant or recipient does not have a SSN, they must have or apply for a Individual Taxpayer Identification Number (ITIN).

CDSS must register IHSS as an employer of record with the Employment Development Department (EDD). To establish the IHSS recipient as an employer of record, EDD requires the recipient to have either a SSN, or, if ineligible for a SSN, apply for an ITIN through the Internal Revenue Service.

Counties cannot deny an IHSS application if the applicant does not have either a SSN or ITIN. The county will redirect applicants who do not have a SSN or ITIN to apply for an ITIN through the Internal Revenue Service. During the process for receiving an ITIN, which can take 60 to 90 days, the county must still process the IHSS application. Counties can help applicants or recipients apply for an ITIN. (ACIN I-70-23, November 21, 2023)

Elimination of IHSS provider eligibility requirements for minor recipients

The California Department of Social Services (CDSS) has issued guidance regarding the end of In Home Supportive Services (IHSS) provider eligibility requirements for minor recipients.  Previously, minors could only hire a non-parent IHSS provider if their parents were not available to be providers.  In addition, parents could only be providers for their minor children if there were no other suitable providers, and the parent was prevented from full-time employment because of the need to care for the child.  Effective 60 days after December 21, 2023 (the date of the release of this ACL) these limits on parent providers are eliminated.

The limits on providers for minors still apply to minor recipients in the Personal Care Services Program.  Counties should ensure that minor applicants who want a parent provider are enrolled in the Community First Choice Option, the IHSS Plus Option, or the IHSS Residual program.  Counties should transfer qualifying minor recipients from the Personal Care Services Program to the Community First Choice Option upon request of the recipient or at the next scheduled reassessment, whichever is first.  Minor recipients who are institutionally deemed and enrolled in the Personal Care Services Program may hire a non-parent provider without limitation.

Other rules for IHSS remain unchanged.  Service assessment rules for minors are unchanged.  Minors remain ineligible for domestic services, heavy cleaning, yard hazard abatement, and teaching and demonstration. Provider enrollment rules are unchanged.  Provider overtime rules and exemptions are unchanged. (ACL 23-106, December 21, 2023.)



IHSS and nonmedical out-of-home care, and unmet need

In Home Supportive Services (IHSS) is available to persons who cannot remain in their own home without services.  Persons who receive SSI can get an additional payment if they are in a non-medical out-of-home living arrangement.

Individuals who receive the SSI non-medical out-of-home care rate are considered not to be living in their own home and are not eligible for IHSS.

IHSS applicants who are eligible for both IHSS and the SSI non-medical out-of-home care rate can choose whether they want IHSS or the SSI non-medical out-of-home care rate. Counties must inform people of this choice.

If an IHSS applicant states that they are not receiving the SSI non-medical out-of-home care rate, but the MEDS system says they are, the applicant must get a letter from the Social Security Administration stating that they do not get the SSI non-medical out-of-home care rate.  The applicant must also complete the SOC 810 form stating that they told the Social Security Administration that they have been discharged from a facility.

When evaluating for IHSS, county social workers must assess for all IHSS services, and must document any unmet need in the case file, identify other resources to meet the unmet need, and refer applicants to those programs at no cost.  (ACL 23-108, December 27, 2023.)

Assessing IHSS applicants when being discharged from out of home placement

The California Department of Social Services (CDSS) has issued a reminder to counties regarding completing preliminary assessment of In Home Supportive Services (IHSS) eligibility for applicants and recipients who are being discharged from hospitals, medical institutions, or non-medical out-of-home placements.

IHSS applicants can be preliminarily assessed and services authorized prior to discharge from the out-of-home placement.  The social worker can help the applicant apply for IHSS while they are in the out-of-home care facility and they must determine what services the applicant will need when they return home.

When there is a referral for an IHSS applicant in an out-of-home facility, counties must complete the assessment in the out-of-home facility.  Counties can get permission from the applicant to work with the facility’s discharge planner or other personal to coordinate documentation for IHSS eligibility.  Counties should prioritize the most vulnerable applicants.

The county must conduct a second needs assessment to determine final service needs when the applicant returns to their own home.

Existing IHSS recipients must inform the county when they are admitted to a hospital or other out-of-home care facility in order to determine services that will not be provided while the recipient is in the facility.  When an IHSS recipient is discharged from an out-of-home care facility and the recipient reports they have additional needs when they return home, the county must do a reassessment.  This reassessment may include working with the facility discharge planner, the recipient’s doctor, or other personnel who are helping with discharge.

Counties should provide all needed IHSS documents to the applicant/recipient prior to discharge.  Counties can email these documents.  With permission, counties can provide the IHSS documents to facility staff.  Counties can work with facility staff to assist in completing documentation.  Discharge paperwork can be accepted instead of the IHSS SOC 873 certification form.  If discharge is to another county, the counties must work with each other.

If the applicant has a provider for when they return home, the social worker should confirm whether they have gone through the provider enrollment process, and if not provide information about how to do that.  If the applicant does not have a provider, the social worker should connect the applicant with the County’s Provider Registry.  (ACIN I-62-23, December 7, 2023.)

Withdrawing state hearing requests

California Department of Social Services (CDSS) State Hearings Division (SHD) has issued instructions regarding withdrawing of a state hearing request.  A claimant or the Authorized Representative can withdraw a hearing request any time before a decision is issued.

A withdrawal can be unconditional or conditional.  An unconditional withdrawal is a complete retraction of the hearing request without conditions.  There are three ways to unconditionally withdraw a hearing request.  A claimant can request an unconditional withdrawal in the ACMS computer system if they have an account.  A claimant can submit a request to unconditionally withdraw their hearing by mail, fax or email.  A claimant can submit a verbal request to unconditionally withdraw their hearing request using the Interactive Voice Response (IVR) system or by telephone.  SHD will send a letter to the claimant confirming the unconditional withdrawal request.

The opposing party may be aware that the claimant wants to unconditionally withdraw their hearing request.  If the opposing party tells SHD that the claimant or their Authorized Representative wants to unconditionally withdraw a hearing request, SHD will contact the clamant to confirm their intent to unconditionally withdraw their hearing request. If the claimant has any questions, SHD will tell the claimant to talk to the opposing party.  If the claimant or Authorized Representative confirms that they want to unconditionally withdraw the hearing request, SHD will enter the withdrawal in ACMS and will send the claimant a letter confirming the unconditional withdrawal.

A conditional withdrawal is a retraction of the hearing request based on the opposing party’s agreement to certain actions to resolve the case.  A conditional withdrawal must be in writing signed by the claimant or their Authorized Representative.

SHD will accept any conditional withdrawal request that is submitted by mail, fax, email, text, IVR, phone, or uploaded to ACMS, that includes written terms and is signed by the opposing party and the claimant.  These methods are considered to be a valid electronic signature.

A claimant or Authorized Representative can confirm a conditional withdrawal by phone with SHD.  The opposing party must contact the claimant to confirm the agreement.  The opposing party cannot rely on a telephonic signature unless they have gotten the claimant’s consent.  If the opposing party parts gets consent, they must upload the terms to ACMS.  SHD will then contact the claimant to confirm the terms.

The claimant or Authorized Representative can use the SHD IVR to state the terms of a conditional withdrawal.  If the opposing party has their own IVR, it can upload a recording of the terms to ACMS.  The agreement must state that the parties complete all terms within 30 days.

If the case has multiple opposing parties, all parties must consent to the conditional withdrawal.

When a case is withdrawn, SHD will notify all parties that the hearing request has been dismissed.

If the claimant or Authorized Representative does not appear at the hearing and a conditional withdrawal has not been processed, SHD will dismiss the case.

A party can withdraw a rehearing request any time before SHD acts on it.  After a rehearing request has been granted, the claimant can withdraw it with the approval of the Chief Administrative Law Judge.  The parties can submit a conditional withdrawal to resolve the case after rehearing is granted.  SHD will review the terms to ensure that all issues in the rehearing are addressed, and then will forward the request to the Chief Administrative Law Judge for approval.  (ACL 23-82, September 19, 2023.)


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.)