Reviews the new rules, and provides a new form, re: IHSS provider obligations (fingerprints, criminal background check, orientation, verification of valid SSN, and more). Includes a flow chart, notices to recipients re: existing and new providers. New providers are not eligible for retroactive payments – they can get paid only after they have completed all the new requirements. Counties must use the new form as of 11/2/09. Providers must report any changes within 10 days, but in any case, the provider form is valid for only one year. There is an appeal process for provider applicants who disagree with the county’s decision to deny the enrollment of a provider for failure to meet the mandated requirements. (So far, just a paper review, but further information on the appeals process will be coming.) [Download]

This letter provides instructions on the Functional Index (“FI”)-based cuts to IHSS. It contains an explanation of the FI ranking and weighted score. Applicants/Recipients must have an FI Score of 2.00 or higher before IHSS services may be authorized. There are 2 (remaining) categories of individuals that would be exempted from any service reductions due to the new threshold level for service eligibility: (1) individuals authorized to receive protective supervision, (2) individuals authorized to receive paramedical services. Terminations will be effective 11/1/09, and instructions for existing recipients and new applicants are listed.

In addition, ABX 4-4 also established a threshold of need that must be met before Domestic and Related Services may be assessed or authorized. In addition to having an FI Score of 2.00 or above to be authorized IHSS, an individual must have a “Substantial Need for human assistance” to receive Domestic or any Related Services. Substantial Need is defined as an FI Rank of 4 or above. The same exemptions, effective date and instructions for existing and new folks apply. [Download]

A “county thing”: Information on a change in the process for reimbursing a missed payment of Medi-Cal Recognized Expenses (the Buyout Program). [Download]

Information regarding two statutory changes to the payment of Medi-Cal Recognized Expenses (MRE) for Personal Care Services Program (PCSP) and IHSS Plus Waiver (IPW) program recipients (known as the SOC Buyout Program). In order to be eligible for the payment of MRE, individuals in PCSP or IPW must be eligible for and receive services under one of those programs before July 1, 2009, and continue to receive those services. (So, new folks to PCSP or IPW, IHSS Residual (IHSS-R) program people, and any one covered who then leaves the programs or loses eligibility are no longer eligible.) Secondly, these individuals will have the MRE payment eliminated as of October 1, 2009. As of that date, the SOC buyout program will be entirely eliminated. Includes a discussion of potential SOC buyout recipients and the treatment of state hearings appeals or Conlan II claims to have their payment of MRE restored, and payment of MRE eligibility for IHSS-R recipients who move to the PCSP or IPW program [ Posted in IHSS
Tagged with IHSS

Information for counties using “contractor mode to provide services to IHSS recipients. CDSS is finishing the design of the new Case Management, Information, and Payrolling System (CMIPS) II. When CMIPS II rolls out, county contractor providers will have to claim time worked in hours and minutes (HH:MM) rather than the current decimal (999.9) format. CMIPS II will be unable to convert the decimal format into hours and minutes, so counties will have to instruct their contractors to make this change to their invoices.[Download]

Information on how to avoid duplication of IHSS services authorized by the county and the Program of All-Inclusive Care for the Elderly (PACE) program. It lists a process for terminating IHSS for Medi-Cal beneficiaries who enroll in PACE. (PACE is an all-inclusive program, designed to coordinate and provide necessary preventive, primary, acute, long term care, social and rehabilitative services through one comprehensive program. It is only in 5 counties. There are no limits on the amount or duration of services.) Download]