IHSS reassessments during COVID-19

The California Department of Social Services (CDSS) has authorized counties to suspend any scheduled In Home Supportive Services (IHSS) reassessments through June 30, 2020.  However, initial assessments must continue to be done face-to-face. Social workers should try to collect as much information as possible by telephone prior to the assessment to minimize the time spent in the applicant’s home.

Counties may continue to conduct reassessments by phone, but any adverse action shall not take effect until June 30, 2020.

Counties should prioritize activities related to applicants and recipients receiving timely authorization of services.  These activities include initial assessments, requests for reassessment because of change in condition or circumstances (including loss of alternative resources because of COVID-19), enrollment of providers, and answering phone calls from providers and recipients.  (ACL 20-26, March 24, 2020.)

90 day suspension of redeterminations, CalWORKs clock stop, and public meeting requirements

Governor Gavin Newsom has issued an executive order regarding public benefits programs in California.  The executive order suspends otherwise required redeterminations for Medi-Cal, CalWORKs, CalFresh , Cash Assistance Program for Immigrants, California Food Assistance Program, and In Home Supportive Services for 90 days.

The executive order also stops the CalWORKs 48 month time clock through June 17, 2020.  Any month or partial month of CalWORKs received will not be counted toward California’s 48 month time on aid limit.

The Executive Order also suspends any requirement of physical presence in the Brown Act or the Bagley-Keene Act for meetings or local or state bodies.  Meetings of state or local bodies held via teleconference and allowing members of the public to observe and address the meeting shall satisfy any requirement that the body allow members of the public to attend the meeting and offer public comment.

The body must have a procedure for reasonable accommodations for persons with disabilities and advertise that procedure in each public meeting notice.  Requirements for notice of the time and agenda for meetings are unchanged, except that the notice of the time of the meeting must also give notice of how the public may observe and comment.  These public meeting provision apply as long as state or local public officials have imposed or recommended social distancing. (Executive Order N-29-20, March 17, 2020.)

Clarification of definition of “own home” for In-Home Supportive Services eligibility

The CDSS has provided clarification regarding the In-Home Supportive Services (IHSS) program definition of “own home” as it relates to alternative living arrangements and IHSS eligibility.  Welfare and Institutions Code Section 12300(a) defines “own home” as “homes or abodes of their own choosing.”  Homeless applicants and recipients often do not have a permanent dwelling that can be viewed as their “own home” because they do not have permanent housing.  However, based on new Welfare and Institutions Code Section 18999.8, the definition of “own home” has been reevaluated to include certain alternative living arrangements.  County staff will evaluate each alternative living arrangement to ensure that authorized services can be delivered in a safe manner considering necessary universal precautions.  While deciding if a location will be eligible, the county should provide all necessary support to the applicant or recipient so that they may remain in the alternative living arrangement or transitional housing and be able to receive IHSS. 

An RV may meet the definition of an “own home” if utilities needed to provide authorized IHSS in a safe manner are available, and the RV can be situated in a single location for a “period of time” sufficient to assess the individuals needs and deliver those authorized services to the recipient.  Such locations include a campground, RV park or other private property where the RV has been authorized to stay for a period of time.  

IHSS recipients living in remote or rural areas, including Native American tribal lands, would be eligible for IHSS even without local utilities services if they have access to alternate resources. In these situations, county social workers should evaluate the specific circumstances of the recipient’s dwelling. 

A homeless shelter could be considered an “own home” if the management of the homeless shelter allows the IHSS recipient to remain there for a “period of time” and allows IHSS staff to perform an IHSS assessment and the IHSS provider to be present in the shelter to provide needed services. An IHSS recipient who moves into the residence of a family member or friend may be considered to be living in his/her “own home” if the family member allows the recipient to remain in the home for a specified “period of time.” Recipients are responsible for notifying the county IHSS office whenever there is a “substantive change in living arrangements.” which would require a reassessment.

If a recipient cannot be located, county IHSS staff should make a good faith effort to communicate with the recipient, including making telephone calls to all known recipient numbers, direct mail, email, in-home visits, and contact with known family or friends of the recipient. All attempts should be documented, and copies of returned mail should be maintained in the recipients case file. After the county staff has attempted to contact the recipient, the county may terminate the case and send a Notice of Action to the recipient’s last known address ten days prior to the termination date of the case.

Certain extraordinary situations may cause an IHSS to lose access to his/her home, but the IHSS recipient can continue to receive IHSS while living in a temporary “alternative living arrangement.” Emergency situations such as these should be considered an “unexpected extraordinary” change in circumstance. County social workers may perform a reassessment at the emergency shelter to determine if a temporary adjustment in the authorized weekly hours of a recipient is necessary. If the recipient is moved from the emergency shelter into temporary housing, the social worker must assess the temporary housing as well. If local utility services have not yet been re-established, the county social worker will need to evaluate the alternative resources to determine if the recipient is still allowed to receive his/her authorized services. 

Welfare and Institutions Code Section 18999.8 authorizes counties to create homeless adult and family interdisciplinary teams to assess homeless individual’s living accommodations and service needs.  Counties that have multidisciplinary teams are developing protocols to assist in transitioning homeless individuals to transition to permanent housing. One of the goals of multidisciplinary teams is to move homeless individuals who need IHSS to a safe and stable living situation where they can receive authorized services.  IHSS social workers should provide all adequate referrals to assist the applicant or recipient in arranging for a safe living environment before denying an IHSS applicant or terminating an IHSS recipient for not meeting the definition of “own home.”  (ACIN I-19-20, February 25, 2020.)

 

IHSS timesheet signature authorization requirements

The California Department of Social Services (CDSS) has issued information regarding the timesheet signature authorization requirement.  An IHSS recipient or their legal representative can designate an authorized representative to sign a provider’s timesheet on their behalf.  For this purpose, a legal representative is a court-appointed guardian or conservator, or for a recipient who is a minor, the parent or other individual who is the legally authorized decision maker for the minor.

To do so, the recipient or their legal representative must complete the SOC 839 Form Part C.  Upon receipt of the SOC 839 form, the county must enter the timesheet signatory information into the CMIPS computer system.  (ACL 19-115, December 17, 2019.)

IHSS Electronic Visit Verification

The California Department of Social Services (CDSS) has issued information about implementation of Electronic Visit Verification (EVV) for In Home Supportive Services (IHSS) providers.  States are required to implement EVV for personal care services and home health programs no later than January 1, 2020.  California received an extension to January 1, 2021 to implement.

CDSS chose to modify the existing Electronic Services Portal and Telephone Timesheet System to allow providers to submit and recipients to verify and approve EVV information.  To do this, CDSS added start time, end time and location fields to the Electronic Services Portal and added functionality to the Telephone Timesheet System.

Los Angeles County piloted the EVV system beginning on July 1, 2019.  Statewide implementation began in January 2020.  The state is divided into five waves.  Each waive will have a two-month roll-out.  Two months prior to each wave, CDSS will send notices to all providers and recipients in the affected counties.  Providers and recipients will receive another notice one month prior to their implementation date.

Counties can hold CDSS-supported information sessions for providers and recipients.  CDSS has been hosting webinars for providers and recipients and will continue to do so until implementation is complete.  Recipients and providers will also be able to call the IHSS Help Desk for assistance.

Counties will be able to defer provider and recipient enrollment if the provider needs to complete  specific activities to enroll such as establishing internet connectivity or identifying a time sheet signatory.

Exceptions from EVV can be granted for recipients if they have no access to landline or internet two times per month or they have a disability verified by a medical doctor that prevents them from using EVV and there is no one available to act as the recipient’s timesheet signatory.   (ACL 20-04, January 6, 2020.)