IHSS

ACL 11-81: Implementation Of Twenty-Percent Reduction IHSS Recipients’ Authorized Hours (11/29/11)

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ENJOINED THROUGH TRO GRANTED 12/1/11

A must read: The state got a budget estimate for next year that set off a trigger to cut IHSS cut. On top of the prior 3.6% cut, IHSS authorized hours (what the state already decided you needed in order to safely stay in your home) will be cut an additional 20%, effective January 1, 2012.  Recipients “choose” which needs will not be met/paid for through IHSS.

The cut does not apply to people who get services under one of the State Home and Community Based Services Waivers (including the AIDS , Home and Community Based Services Waiver for the Developmentally Disabled , In-Home Operations (IHO), Multipurpose Senior Services Program , and Nursing Facility/Acute Hospital waivers).

IHSS recipients who believe they have a “serious risk “of out-of-home placement may submit an application for IHSS Supplemental Care to request full or partial restoration of his/her reduced hours.  The criteria for preapproving IHSS Supplemental Care requests is also described.   The letter also contains a “screening tool” for the counties to assess “serious risk” of out of home placement.  Recipients must make their request for Supplemental Care by March 1, 2012. If the recipient submits an IHSS Supplemental Care application within 15 days of receiving
the NOA, or postmarked by January 3, 2012, the pre-cut hours will be restored.  However, even if the person is at “serious risk” the county has several options: Assist the recipient to to prioritize the hours available so that the most essential tasks are completed so the serious risk is eliminated; arrange for the recipient to receive services from a formal or informal alternative resource (i.e., home delivered meals, neighbors to take the recipient grocery shopping with them, etc.); restore part of the hours to ensure that the serious risk is eliminated; or restore all of the hours to ensure that the serious risk is eliminated.

Here’s the timeline: November: reprogram CMIPS; December (by the 15th), mail out NOAs of the cut; counties must send a more detailed notice of the cut along with that NOA.

 

Counties must continue to perform reassessments. However, if a request for a reassessment is received within 90 days of the reduction NOA, the county should evaluate whether the request is disputing the reduction or whether there has been a change in the recipient’s circumstances that impacts his/her functional abilities. As part of this evaluation process, when necessary, counties may request additional information from the recipient to document the change in circumstances necessitating a reassessment.

The letter also helpfully informs counties they should “prepare” for an “increase” in calls.  The letter states that fair hearings will only be held after denial of the supplemental care application, but that aid paid pending will be available if the request is timely filed (i.e. BOTH the supplemental care application AND the hearing request if denied). The NOA to the clients state they will get APP if they file a hearing request before 1/1/12. [Download]

ACL 11-76: IHSS Health Care Certification Form Exceptions (11/10/11)

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Remember budget bill SB 72? It required an IHSS certification form, the SOC 873 to be received prior to the authorization of IHSS services for new applicants and to allow the continuation of IHSS services for current recipients. There are two exceptions to this rule as it relates to applicants, who are considered temporarily eligible if they meet the exceptions. 1) IHSS services have been requested on behalf of an individual being discharged from a hospital or a nursing home and those services are needed to enable the individual to return safely to their own home or into the community; 2) Services may be authorized temporarily pending receipt of the certification when the county determines that there is a risk of out-of-home placement.  The SOC 873 or appropriate documentation must be received within 45 days, or 90 with good cause.  There are instructions about the NOAs required. [Download]

ACL 11-56: Public Authority Administrative Allocation For Fiscal Year (FY) 2011-12 and the Establishment Of An Allocation Of $3,000 General Fund For Public Authority Advisory Committee Expenses to the Public Authorities in Accordance with Welfare and Institutions Code Section 12301.6 (7/29/2011)

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This letter provides the general fund allocation amounts by county for administrative costs associated with In Home Supportive Services Programs. [Download]

ACL 11-55: IHSS Medical Certification Form (7/27/11)

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Starting August 1st, all new IHSS applicants must have a new form SOC 873 completed.  Recipients must have the form completed around the time of their reassessment. (The ACL also describes alternative documentation to the 873 that will be acceptable.) New WIC section 12309.1 required a medical certification form that includes a declaration from a licensed health care professional that the applicant/recipient is unable to independently perform some activity of daily living and that without the assistance of IHSS services, the applicant/recipient would be at risk of placement in out-of-home care. The form must also include a description of any condition or functional limitation that has resulted in, or contributed to, the applicant/recipient’s need for assistance. (Same purpose, new look.)  Individuals will have 45 days from the date the county requests the form to obtain the verification, with good cause extensions for recipients (but not applicants).  The form must have questions 5 and 6 completed.  The county will perform an assessment only if both 5 and 6 answers are YES.  If either is a “no” IHSS will be denied, and for recipients, services terminated. Once the new form is completed, it does not need to be done at subsequent reassessments, as counties can use the 873 or their own form at that time.

Counties can give the form to the applicant/recipient, but if the person requests assistance, the county must send it for them.  (Even if the county sends the form, it is the individual’s responsibility to ensure it is returned, but can sign the release section on the form, which permits the counties to contact the provider.)  If 5 and 6 are marked “yes” the form will not be the sole determinative factor in services, as usual.   [Download]

ACL 11-19: IHSS Plus Option (IPO) (2/23/11)

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Before you get too excited that IHSS is going public with an offering, this letter sets out more info on the implementation of the In-Home Supportive Services Plus Option (IPO) program. Unlike the Demonstration Waiver IPW, the IPO is a State Plan Option, and therefore follows the State Plan PCSP regarding program eligibility and services.  Under the IPO program, eligibility is the same as for PCSP (categorically or medically needy and has a disabling condition) . The IPO does not include teaching/demonstration, and has different program rules regarding care provided by a spouse/parent. There are also enhanced assessment processes. CDSS is in the process of developing regulations for the IPO.   [Download]

ACL 11-12: Criminal Background Checks For IHSS Providers; Expansion Of Exclusionary Crimes; Individual Waivers And General Exceptions Of Exclusions (1/26/11)

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Implementing instructions for changes, effective 2/1/11, to W&IC 12305.87, which expands the list of crimes for which a conviction, or incarceration following a conviction, within the last ten years would exclude an individual from being enrolled as an IHSS provider. The statute also establishes provisions which will permit an individual, under certain circumstances, to be enrolled as an IHSS provider in spite of a conviction for an exclusionary crime.  In addition to the original set of crimes (now called “Tier 1”) the legislation now covers “Tier 2 exclusionary crimes” (A violent or serious felony, a felony offense for which a person is required to register as a sex offender, and a felony offense for fraud against a public social services program). The Letter includes a complete listing of Tier 2 exclusionary crimes, the specific code sections, and title as well as “plain English” descriptions of the crimes.

An applicant provider found ineligible on the basis of a conviction(s) for a Tier 2 crime, but who otherwise meets all of the provider enrollment requirements, may be permitted to provide services to a specific IHSS recipient(s) if the recipient(s) who chooses to hire the individual despite the conviction(s) submits a request for an individual waiver of the exclusion.  The letter reviews the  notice and forms to be used for this waiver. [Download]