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.)

Sexual harassment in the IHSS program

The California Department of Social Services (CDSS) has issued information about AB 3802 which requires CDSS to develop or identify educational materials to be made available to IHSS recipients and providers, and to propose a data collection method for the prevalence of sexual harassment in the IHSS program.

CDSS developed education materials, SOC 2326 and SOC 2327, which suggest methods to identify, prevent and resolve sexual harassment situations in the IHSS program.

The Department of Fair Employment and Housing (DFEH) will identify IHSS sexual harassment cases.  Reports can be extracted from DFEH’s database.  (ACIN I-70-19, November 18, 2019.)

IHSS overtime exceptions for extraordinary circumstances

The California Department of Social Services (CDSS) has issued guidance regarding exceptions from the IHSS provider overtime limits for extraordinary circumstances.  In general exceptions from the overtime limits are available if (1) the recipient has complex medical or behavioral needs that must be met by a provider who lives in the same home as the recipient; (2) The recipient lives in a rural or remote area where available providers are limited or (3)–The recipient is unable to hire another provider who speaks the same language as the recipient.  (See ACL 18-31.)  These criteria are called the Exemption 2 criteria.

When there is a request for an Exemption 2 overtime exemption, the county must accept the request regardless of whether it appeals the provider will be determined eligible.  When a verbal request is made, the county should provide the individual with a form SOC 2305.

Counties can rely on information in CMIPS but should not deny an Exemption 2 request based only on information in CMIPS.  Counties must talk to the provider, the recipients, the assigned social worker and any other active providers to determine whether the exemption requirements are met.

Counties must document the justification for an Exemption 2 determination in CMIPS including the criteria evaluated, why the determination was made, the attempts made by the recipients to hire additional providers and why those attempts were not viable, and a description of the assistance provided by the county in attempting to identify an additional provider.

Recipients are not required to exhaust all options for hiring an additional provider.  Individuals are required to make reasonable attempts to hire additional providers.

The Exemption 2 policies are separate from and do not supersede any other IHSS program rules.  Although changes in need may impact the continued need for an overtime exemption, requests regarding IHSS needs should be evaluated using IHSS program rules.  For example, a request for reassessment should not be denied because there is an overtime exemption.  The receipient’s needs should be reevaluated, and then any impact on the overtime exemption should be determined.

For minor recipients with a parent provider, the county should first evaluate whether the parent is an eligible provider, and if so, then evaluate eligibility for an overtime exemption.

The provider can reapply for an Exemption 2 at any time.  However, to be reevaluated, there must be a change in the provider or recipient’s circumstances which has the potential to make a previously ineligible provider eligible for an overtime exemption. County staff should contact the individual within 10 days to determine the change in circumstances.

If the county determines that there has not been a significant change in circumstances, the county should not accept the application and should send a SOC 2325 form.

An Exemption 2 is terminated if the provider with an exemption is assigned to a new recipient’s case, terminated from the case of one of the recipients included in the exemption, or the recipient included in the exemption is terminated from IHSS.

Cases approved for an Exemption 2 should be reevaluated annually.  (ACL 19-100, October 29, 2019.)

IHSS overpayment recovery

The California Department of Social Services (CDSS) has issued instructions about recovery of overpayments in the In Home Supportive Service Program (IHSS).  An overpayment includes any payments to a recipient to purchase IHSS services in an amount to which the recipient was not entitled.  Counties must recover the full amount of IHSS overpayments.  However, prior to initiating overpayment recovery, counties must confirm there has been a conviction for fraud against the IHSS program.  Once a fraud conviction has been established, counties can proceed with overpayment recovery.

CDSS has issued two new notices of action, NA 1284 for recipient fraud conviction and NA 1283 for advance pay recipient fraud conviction.  (ACL 19-81, August 8, 2019.)

Union eligibility for Waiver Personal Care Services providers

The California Department of Social Services (CDSS) has issued instructions implementing AB 1811 Section 34 which establishes the county, public authority or nonprofit consortium as the employer of record for Waiver Personal Care Services providers for purposes of good faith negotiations regarding wages, health benefits and other conditions.

Effective July 1, 2019, Waiver Personal Care Services providers have the same collective bargaining rights, wages, health benefits and other conditions as In Home Supportive Services providers in their respective counties.  Waiver Personal Care Services providers are now eligible for health benefits administered by the county and are eligible to become union members.  (ACL 19-61, June 28, 2019.)