The California Department of Social Services has issued instructions regarding IHSS time for Medical Accompaniment.  Accompaniment to health care appointments and alternative resource sites is an allowable IHSS service.  CDSS states its policy is Medical Accompaniment can only be authorized when the recipient needs assistance with another IHSS authorized task during transportation or at the medical appointment or alternative resource site.  CDSS policy is Medical Accompaniment is not authorized only to fill the recipient’s need for transportation. Wait time is available for appointments when the provider provides authorized Medical Accompaniment and the provider is not performing work duties but is unable to use the time for their own purposes.

CDSS policy is that Medical Accompaniment is generally unavailable for minor recipients because it is a parental responsibility to accompany children to medical appointments.  Medical Accompaniment for a minor can be authorized only if the minor has an assessed extraordinary need, the appointment is for specialty care, and the minor has a need for another IHSS authorized task during transportation or at the medical appointment.  Although Medical Accompaniment is not available for routine medical appointments, if the minor recipient needs other authorized services based on assessed extraordinary need, the provider may be paid for assistance with another IHSS authorized task during transportation or at the medical appointment.  Wait time is also generally unavailable for minor recipients, with limited exceptions such as a medical professional taking physical charge of the minor recipient for a set period of time and there is enough time for the parent provider to conduct their own personal business.

Medical Accompaniment is available for appointments only when the county verifies that the recipient is not receiving Medi-Cal non-emergency medical transportation for that appointment.  When a recipient receives non-emergency medical transportation for an appointment, but the recipient needs assistance with another IHSS authorized task during transportation or at the medical appointment, Medical Accompaniment can be authorized, but only for the amount of time for travel to and from the recipient’s home to the appointment.  This is because the time for the other IHSS authorized tasks should already have been accounted for in the total authorization for those service categories.  (ACL 17-42, June 23, 2017.)

The California Department of Social Services (CDSS) has issued instructions about IHSS eligibility for children in Adoption Assistance Program (AAP) or Foster Care.  Children who receive AAP benefits who apply for IHSS must receive a comprehensive needs assessment.  Children who receive AAP can be eligible for IHSS.  AAP cannot be considered an alternative resource when determining the number of hours of IHSS eligibility.

Children placed in with an approved resource family or in a setting that must be approved as a resource family prior to December 31, 2019 are considered to be residing in their own home and are eligible for IHSS.  Children placed with a relative or with Non-Relative Extended Family Member are also eligible for IHSS.  Children who live in licensed community care facilities such as group homes, short-term residential therapeutic programs and transitional housing placement providers are not eligible for IHSS as long as they are in those placements because they are not residing in their own home.  (ACIN I-40-17, June 23, 2017.)

Previously, the California Department of Social Services (CDSS) instructed that IHSS providers who did not sign the SOC 846 provider agreement by April 29, 2017 would be terminated from the program.  CDSS has rescinded this policy.  CDSS states that most providers completed and returned the SOC 846 and all providers have received the information contained in the SOC 846. As a result, no disciplinary action will be taken against IHSS providers who do not sign and return the provider agreement.  (ACL 17-43, May 19, 2017.)

CDSS has issued instructions about the IHSS overtime exemption for extraordinary circumstances.  The criteria and initial instructions for the IHSS overtime exemption for extraordinary circumstances are in ACL 16-22, summarized here.

CDSS’ new instructions address renewal of an extraordinary circumstances exemption.  All conditions on which the exemption was initially granted must remain the same for an exemption to be renewed.  If there has been any changes, the county must submit to CDSS a referral for a new exemption instead of renewal of the existing exemption.

Prior to submitting the renewal request, the recipients must explore and exhaust all options for hiring additional providers in the same manner as for the initial exemption request.  This includes contacting relatives, friends, neighbors or other people the recipient knows about their willingness to be a provider, contacting provider registries both in the county where the recipient lives and in neighboring counties, and utilizing alternative resources such a Regional Center services, to address issues with the recipient’s ability to tolerate an outside provider.

CDSS eliminated the requirement to perform a renewal at the next face-to-face reassessment when reassessment occurs before the end of the six month or one year period of the exemption.  However, requests for renewals must be submitted to CDSS by the county no less than 30 days before the exemption ends.

CDSS also clarified that counties determine when to submit exemption requests to CDSS and the county shall not submit either an initial referral or request to renew to CDSS if the county decides other resources are available.  (ACL 17-13, April 7, 2017.)

CDSS has issued instructions implementing AB 1797 about confirmation numbers for IHSS applications.  AB 1797 added Welfare and Institutions Code Section 12301.16 that requires counties to provide HIS applicants with a confirmation number upon receipt of an IHSS application.

CDSS will use the case number that is randomly assigned by the CMIPS II computer system as the confirmation number.  CDSS developed a notice called “Notice of Application Confirmation Number (SOC 2300)” for IHSS agencies to use when providing notification of the application confirmation number.  Counties must provide the confirmation number either verbally before the end of a telephone call during which an IHSS application is taken or in writing when the application is entered into CMIPS II.  (ACL 17-18, February 16, 2017.)