IHSS 7% reduction restored

Effective July 1, 2015, the IHSS 7% reduction is restored. The 7% reduction was part of the settlement in the Oster v. Ligthbourne litigation and was codified in Welfare and Institutions Code Sections 12301.01 and 12031.02. In SB 97 (the budget act, Section 57, Part 6), the legislature suspended the reduction for one year, from July 1, 2015 to June 30, 2016. In a special legislative session later this year, the legislature will attempt to determine funding sources for making the restoration of the 7% reduction permanent.

Notices of the possibility that the 7% reduction would be restored were scheduled to go out in mid-June. The notices say that restoration was a possibility because the restoration legislation had not yet passed.

The IHSS computer system called CMIPS II is supposed to automatically create a new IHSS authorization with the restored hours added, and to automatically updated provider hours. The ACL warns that there may be an issue assigning the hours when a recipient has multiple providers and if the recipient wants hours divided differently between multiple providers, the recipient needs to file a SOC 838 form with their county.  ACL 15-57

Instructions to determine IHSS eligibility for “non-disabled” people with MAGI Medi-Cal

Under the ACA, 19 to 64 year olds who are neither disabled nor blind can be eligible for Medi-Cal if if their modified adjusted gross income (MAGI) is below a certain amount.  There are several MAGI aid codes, many of which indicate eligibility for full-scope Medi-Cal with federal financial participation (FFP).  For such individuals who have not yet been determined to be disabled by CDSS or the Social Security Administration, they may still receive IHSS if they (1) meet the criteria for disability under MPP Section 30-780.2(b), and (2) have an assessed need for IHSS.  ACL 14-67.

Federal judge halts implementation of new IHSS overtime rules

On January 14, 2015, Judge Richard Leon of the U.S. District Court, District of Columbia issued a ruling vacating the U.S. Department of Labor’s revised companionship services definition scheduled to take effect the following day. In response, CDSS has postponed changes related to overtime, travel time and wait time pay for all IHSS providers. The forms and notices previously issued to implement the changes will not be used. Notices were to issue to all IHSS providers and recipients informing them 2014 hours allocations will remain in effect and the planned 61-hour limit will not take effect. The Department of Labor has appealed Judge Leon’s ruling.  ACL 15-10.

IHSS provider enrollment orientation rules change next month

Beginning April 1, 2015, prospective IHSS providers must attend an in-person provider enrollment orientation that includes training and materials detailing the applicable federal and state minimum wage, overtime, travel time and wait time laws. Counties must provide the orientation in English and any language spoken by five percent or more non-English speakers in the county. The county’s recognized employee organization must be permitted to make a presentation at the orientation. These changes are pursuant to SB 878. In addition, prospective providers may no longer use printouts from the Social Security Administration as original documentation of identity. However, Social Security cards, state driver’s licenses or identification cards and tribal identification cards are still accepted. ACL 14-102.

New IHSS time sheet and reimbursement processes implemented

IHSS providers who provide services to different recipients at different locations on the same workday are now eligible to be paid for up to 7 hours of travel time per work week in accordance with Welf. & Inst. Code §12300.4(f).  Such providers, effective January 1, 2015, must now submit the IHSS timesheet with travel (SOC 2262) and the travel claim form (SOC 2275) to be paid for their travel time.  ACL 14-103.

Clarification for using personal care services to meet Medi-Cal share of cost

DHCS recently clarified the process for using out-of-pocket expenses from personal care services to meet current or future share of cost amounts.  Previously, IHSS needed to assess and approve the need for personal care services, and the out-of-pocket costs of approved hours were used as an income deduction.  Since these services are now provided as a Medi-Cal benefit, out-of-pocket costs can now be used to meet share of cost and not income deductions.

These out-of-pocket personal care services must be prescribed by a healthcare professional.  The services need not be assessed by IHSS or provided by an IHSS provider, and they may exceed the maximum assessed IHSS hours as long as the need for hours has been documented.

The letter provides answers to frequently asked questions about using these out-of-pocket expenses toward the Medi-Cal share of cost.  DHCS ACWDL 15-02 (1/12/15).