Transcript IN HOME SUPPORTIVE SERVICES - Disability Rights California

OCRA ORIENTATION
IN HOME SUPPORTIVE
SERVICES
TWO PROGRAMS
In-Home Supportive Services (IHSS) are
operated under two programs, both of which
are administered at the county level under
the Department of Social Services. They are
the former Residual Program, now replaced
by the Independence Plus Demonstration
Waiver, and the Personal Care Services
Program (PCSP).
RESIDUAL PROGRAM
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The Residual Program was in existence from 1973
to July 2004, when it was replaced by the
Independence Plus Waiver Program.
The Residual Program’s funding structure was
65% State, 35% County, with no federal funding.
Under the Residual Program, parents of minors
and spouses could receive payment for providing
In-Home Supportive Services. Also, a recipient
could receive Advance Payment for services.
In order to receive protective supervision, a
recipient had to be under the Residual Program.
PCSP
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This is Medi-Cal funded program that began on April 1,
1993, as a way for the State to curb its costs in funding for
IHSS. On April 1, 1999, categorical aid payment (i.e., SSI
receipt) became unnecessary for eligibility under PCSP.
PCSP’s funding structure is 50% Federal, 32.5 % State,
and 17.5% County.
Services under the PCSP were limited to Personal Care and
Ancillary, i.e., Domestic/ Related Services. One could not
receive protective supervision or advance pay, and parents
and spouses could not be providers.
Eligibility for PCSP requires one to have personal care
services needs. You are ineligible if your only needs are
for ancillary services, such as housecleaning.
INDEPENDENCE PLUS
DEMONSTRATION WAIVER
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This program is Medicaid-funded and has replaced the
Residual Program. Because this program is so new, little
details are yet known about it. Stay tuned, as information
from the Departments of Health and Social Services should
be forthcoming. Until then, continue to refer to the
Residual Program laws and regulations.
Under the Independence Plus program, parents and spouse
providers will be allowed. Also, advance payment will
also available under this program
California has redefined its definition of personal care
through an amendment to its Medicaid State Plan to
include protective supervision. This means that protective
supervision should now be available under PCSP.
RESIDUAL PROGRAM LAWS
California Welfare and Institutions Code §
12300 et seq.
 Manual of Polices and Procedures (MPP)
§§ 30- 700 through 30-776, available at:
 http://www.dss.cahwnet.gov/getinfo/pdf/ss2
.pdf
 http://www.dss.cahwnet.gov/getinfo/pdf/ss3
.pdf
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PCSP LAWS
California Welfare and Institutions Code §
14132.95
 Manual of Polices and Procedures (MPP)
§§ 30-780, available at:
 http://www.dss.cahwnet.gov/getinfo/pdf/ss4
.pdf
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SERVICE AUTHORIZATION
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The regulations pertaining to Needs Assessments are
located at: MPP §§ 30-761,763.
PAI’s publication for Self-Assessment is available at:
http://www.pai-ca.org/pubs/501301.pdf
There are statutorily-imposed maximum authorizations for
IHSS: 195 hrs/month for “Non-Severely Disabled”
recipients and 283 hrs/month for “Severely Disabled”
recipients.
You are considered “Severely Disabled” when your need
for the following services, in the aggregate, exceed 20
hrs+ per week: all personal care services, paramedical
services, meal preparation, and meal clean up when
feeding is also necessary.
SERVICE AUTHORIZATION
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Advance payment is available for paying your providers
when you are considered “severely disabled.”
You can be eligible for “Split Program” services when
have been determined “non-severely disabled” but are in
need of protective supervision and some personal care.
You would receive 195 hours under Residual Program plus
hours for personal and ancillary care under PCSP up to 283
hours per month total.
A relatively new law establishing “Waiver Personal Care
Services” (WPCS) allows for additional hours beyond 283
hrs/month. However, recipients must be enrolled in an
IHO-administered Home and Community-Based Waiver to
obtain WPCS. See WIC § 14132.97.
ALL COUNTY LETTERS
http://www.dss.cahwnet.gov/lettersnotices/
AllCountyL_551.htm
 ACL 98-53: Regional centers not alternative
resources
 ACL 98-79: Interim emergency regional
center services not alternative resources
 ACL 98-87: Assessing minors for protective
supervision
 ACL 00-28: Voluntary Services Procedures
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ALL COUNTY LETTERS
ACL 00-83: Zero Share of Cost PCSP for
Recipients under the DDS Waiver
 ACL 02-43 and Errata: IHSS and EPSDT
Services Coordination
 ACL 02-68: County Obligation to Assess
Applicants For IHSS Prior to Discharge
From Hospitals/Nursing Facilities
 ACL 03-24: Waiver Personal Care Services
 ACL 04-43: IHSS in the Workplace
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