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.)

 

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.)

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.)

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.)

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.)

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.)