The California Department of Social Services has issued information about new regulations implementing IHSS provider enrollment rules and procedures.  These rules and procedures include 90 days to complete the provider enrollment process with a  possible 45 day extension for good cause, attending an in-person orientation, fingerprinting for criminal background check, notice of eligibility or ineligibility to be enrolled as a provider and waiver of disqualifying convictions.  In addition, the county will determine whether a provider has legal authority to work in the United States.

The new regulations also specify that an enrolled provider cannot be required to complete the provider enrollment process when the provider moves from one county to another.  The county that the provider moved from is obligated to give the new county the criminal background check clearance documents and the new county must accept that documentation.  ACL 16-53 (July 7, 2016).

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).

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).

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).

CDSS has issued instructions for the live-in family care exemption from the new IHSS overtime rules. Instructions about the workweek rules are in ACL 16-01. There are two exemptions from these rules for IHSS providers. An IHSS provider who, on or before January 31, 2016, is providing services to two or more live-in family member, can work up to 12 hours per day or 90 hours per week, not to exceed 360 hours per month. The criteria for this exemption are: 1) The provider works for two or more IHSS recipients, 2) The provider lives in the same home as all of the IHSS recipients for whom services are provided and 3) The provider is related to all of the IHSS recipients for whom services are provided as parent, adoptive parent, step-parent, grandparent or legal guardian. This exemption does not apply to providers who do not meet these criteria prior to February 1, 2016.

This exemption does not change the rules regarding minor IHSS recipients living in two parent households. However, a non-parent provider can provide IHSS for any remaining hours that cannot be provided by the parent provider who is limited to 360 hours per month.

There is also an exemption from the workweek rules extraordinary circumstances which place the IHSS recipient at imminent risk of institutionalization. A potential example is where no other caregiver who speaks the recipients primary language can be located in the community. These exemptions will only be granted on a case by case basis. CDSS issued ACL 16-22 with criteria and requirements for the extraordinary circumstances exemption.  ACL 16-07 (January 21, 2016).