IHSS

IHSS application processing and reassessments

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The California Department of Social Services (CDSS) reiterates the In Home Supportive Services (IHSS) requirements for processing applications, completing reassessment, and issuing Quality Improvement Actions Plans.  

Individuals have the right to apply for IHSS services or make an application through another person on their behalf. Counties are required to accept IHSS applications by telephone, by fax, or in person.  If the county has the capability, it must also accept applications online and by email. The applicant’s protected date of eligibility is the date the applicant requests services. Case Management, Information and Payrolling System (CMIPS) will automatically check for Medi-Cal eligibility. If the applicant is ineligible for Medi-Cal when they apply, they may be authorized services back to the protected date of eligibility. Prior to authorization of IHSS services, recipients must submit a Health Care Certification form (SOC 873) completed by a licensed health care professional, except when the recipient is at imminent risk of out of home placement.

People at imminent risk of out of home placement can be granted IHSS immediately, and be given 45 days to submit the health care certification, and can have up to 90 days for good cause.  

For purposes of monitoring counties’ compliance with application processing, CDSS will use the protected date of eligibility, and a 90-day timeframe to allow for the 45 days which may be necessary to complete the required Medi-Cal eligibility determination and the Health Care Certification form.

Counties must reassess individuals’ IHSS eligibility every year, and each time a recipient notifies the county of a change in circumstances. Counties should prioritize Communities First Choice Options (CFCO) annual reassessments because these recipients are typically most vulnerable. 

Although CDSS requires 100% compliance with reassessments, CDSS will issue a Quality Improvement Action Plan for counties that are below 90% compliance rate for CFCO recipients and an 80% compliance rate for all other recipients.  (ACIN I-58-21, June 14, 2021.)

COVID-19 Supplemental Paid Sick Leave for IHSS providers

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The California Department of Social Services (CDSS) has provided information about State Supplemental Paid Sick Leave for In Home Supportive Services (IHSS) providers.  Supplemental Paid Sick leave provides 80 hours of sick leave for IHSS providers in addition to the regular 16 hours of sick leave provided by the IHSS. State Supplemental Paid Sick Leave is available for IHSS providers when the provider is unable to work for a reason related to the COVID-19 pandemic. 

Supplemental Paid Sick Leave is available retroactively to January 1, 2021.  For claims for sick leave prior to March 31, 2021, counties should verify whether a previous sick leave claim was submitted.  If a claim was not previously submitted, federal Emergency Paid Sick Leave Act (EPSLA) funds must be used before State supplemental paid sick leave for leave prior to March 31, 2021. While EPSLA placed providers on a two week paid leave, State Supplemental Paid Sick Leave is claimed in hourly increments, as determined by the county. 

IHSS providers taking sick leave must not be listed on a timesheet for any hours the recipient claims for paid sick leave. 

Reasons to be qualified for State Supplemental Paid Sick Leave include:

  • The provider is subject to a quarantine or isolation period related to COVID-19 as defined by an order or guidelines of the State Department of Public Health, the CDC, or a local health officer.
  • The provider has been advised by a health care provider to self-quarantine due to concerns related to COVID-19.
  • The provider is experiencing symptoms of COVID-19 and is seeking a medical diagnosis.
  • The provider is attending an appointment to receive a vaccine for protection against contracting COVID-19 (Up to a maximum of 4 hours).
  • The provider is experiencing symptoms related to a COVID-19 vaccine that prevents the provider from being able to work.
  • The provider is caring for a family member who has been advised to self-quarantine due to concerns related to COVID-19.
  • The provider is caring for a child whose school or place of care has been closed or is determined otherwise unavailable for reasons related to COVID-19 on the premises. 

CDSS has revised the COVID-19 paid sick leave request form to allow requests based on federal or state requirements. CDSS has notices for both providers and recipients to inform them of the new State supplemental paid sick leave. Providers will be informed of their ability to submit claims for State supplemental paid sick leave and under what circumstances they may claim it. Recipients will be informed of their ability to request an emergency back-up provider, should their primary provider need to claim federal emergency or State supplemental paid sick leave related to the COVID-19 pandemic.

Supplemental Paid Sick Leave is available until September 30, 2021. (ACL 21-36, March 30, 2021.)

New IHSS medical accompaniment for COVID vaccines

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In Home Supportive Services recipients age 16 to 64 are now eligible to receive a COVID-19 vaccine.  IHSS recipients who need assistance from their provider to get a COVID-19 vaccine can use medical accompaniment hours for that purpose.  Recipients who need additional hours for this purpose, or who do not have medical accompaniment time but need it to get their vaccine can get a one-time payment for providers for up to four hours (two hours per vaccine appointment) per recipient.

CDSS is sending informing notices to IHSS recipients.  IHSS recipients aged 16 to 64 will get a letter which they can use to verify that they are IHSS recipients and the Vaccine Medical Accompaniment Claim Form.  IHSS recipients age 65 or older will only get a copy of the Claim Form.

No adjustment to existing service hours is needed, and hours for vaccine medical accompaniment will not be counted towards the provider’s weekly hours.  (ACL 21-31, March 15, 2021.)

COVID-19 extension of sick leave for IHSS providers

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The California Department of Social Services (CDSS) has issued information about the extension of two weeks of emergency paid sick leave in the Families First Coronavirus Response Act for In Home Supportive Services (IHSS) and Waiver Personal Care Services (WPCS) providers.  The Consolidated Appropriations Act extends the paid sick leave provisions of the Families First Coronavirus Response Act until March 31, 2020.  An IHSS or WPCS provider may request sick leave once from April 2, 2020 until March 31, 2021 if the provider is unable to work because of one of six listed COVID-19 related reasons.  The extension to March 31, 2021 does not create additional sick leave hours for providers who already used their Families First Coronavirus Response Act emergency sick leave.

Full-time employees (working 40 or more hours per week) are entitled to 80 hours of paid sick leave.  Part-time employees are entitled to the average number of hours that they work over a two-week period.

When a provider needs to take COVID-19 sick leave, they should complete the COVID-19 sick leave form, TEMP 3021 and submit the form to their IHSS county office.  WPCS providers submit the form to the Department of Health Care Services.  (ACL 21-06, January 19, 2021.)

End of proration of IHSS protective supervision

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The California Department of Social Services (CDSS) has information regarding the end of prorating of In Home Supportive Services (IHSS) protective supervision.

Protective supervision is an IHSS service for observing non-self directing, confused, mentally impaired or mentally ill persons who need 24-hour per day supervision to remain safely in their home.  Previously, when two or more recipients in the same household were eligible for protective supervision, the need was considered to be met in common and the hours were prorated.  Effective July 1, 2020, protective supervision will no longer be prorated when two or more protective supervision recipients live in the same home.

Counties must ensure that recipients understand that their IHSS hours may increase because protective supervision hours are no longer prorated.  County should inform recipients of workweek limitations and the possible need for additional care providers because of the increased hours.  (ACL 20-111, October 13, 2020.)

COVID-19 reinstatement of IHSS overtime violations

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The California Department of Social Services (CDSS) has reinstated overtime and travel time violations for IHSS providers that were suspended because of COVID-19.

In ACL 20-32, CDSS stated that overtime and travel time violations incurred while performing services that were in critical need because of the COVID-19 state of emergency would be removed.

Effective September 1, 2020, violations for exceeding overtime and travel time limits are reinstated.   Going forward, counties should use the process in ACL 16-46 to determine requests to rescind overtime and travel time violations for services that are necessary because of COVID-19.  Counties can override overtime violations if: 1) the additional hours are necessary to meet an unanticipated need; 2) the additional hours are related to an immediate need that could not be postponed until a backup provider arrives; and 3) the additional hours are related to a need that would have a direct impact on the IHSS recipient and would have been needed to ensure their health or safety.

COVID-19 may require IHSS providers to work additional hours of overtime.  These hours may fall under the above criteria. Counties should consider such situations when determining whether to override an overtime or travel time violation.   (ACL 20-103, September 8, 2020.)