This publication provides information about California’s new Back-Up Provider System for In-Home Supportive Services (IHSS) and the Home and Community Based Alternatives (HCBA) Waiver Personal Care Services (WPCS) programs.  If you need help getting services in the community to remain at home or move out of a facility, contact Disability Rights California toll free at (800) 776-5746 or TTY: (800) 719-5798. You can also visit our website at www.disabilityrightsca.org.

In-Home Supportive Services (IHSS) and Waiver Personal Care Services (WPCS)

The IHSS and HCBA WPCS programs provide attendant care services to people with disabilities, including children.  IHSS and WPCS allow people to remain safe at home instead of living in a long-term care facility like a nursing home or board and care.  IHSS and WPCS are provided by a caregiver in a person’s home.  An IHSS or WPCS caregiver can be a family member or someone else chosen by the person receiving IHSS and/or WPCS.

For more information about IHSS, you can visit DRC’s IHSS Self Advocacy Resource page at: https://www.disabilityrightsca.org/resources/in-home-supportive-services-ihss or the California Department of Social Services (CDSS) website at: https://www.cdss.ca.gov/in-home-supportive-services.  You can contact your local County IHSS office to apply for IHSS services: https://www.cdss.ca.gov/inforesources/county-ihss-offices.

For more information about Home and Community Based Services (HCBS) waivers and how to apply for services you can visit our Health Care Self Advocacy Resource page at: https://www.disabilityrightsca.org/resources/health-care?page=1

The Back-Up Provider System

The California Department of Social Services has established a permanent Back-Up Provider System (BUPS) for IHSS and HCBA WPCS.  The BUPS program provides temporary IHSS or WPCS from back-up providers to eligible individuals who receive IHSS and WPCS because their regular providers are unavailable.1 The BUPS program can be operated by the County or Public Authority.  You can contact the Public Authority or County in which you live to ask for BUPS services:

• A list of counties with public authorities can be found online at: https://www.capaihss.org/public-authorities/.
• A list of County IHSS Offices can be found online at: https://www.cdss.ca.gov/inforesources/county-ihss-offices.

BUPS Maximum Hours and Exceptions

Under BUPS, eligible recipients are provided with a maximum total number of 80 hours each state fiscal year (July 1 to June 30) and will reset to 80 hours on July 1 of each year.  Exceptions to the 80-hour annual limit are granted on an as-needed basis for severely impaired recipients.  The exceptions cannot exceed 160 hours of IHSS or WPCS per fiscal year.  These exceptions can only be granted if the funding for the exception is made available in the annual State Budget Act.  This means that if funding for the exception is not available in the state budget for the fiscal year, exceptions to 80-hour annual limit will not be granted during that period.

BUPS hours used count towards the recipient’s total monthly authorized IHSS/WPCS hours and should not change the monthly authorized hours or maximum number of hours authorized.2 For example, if an individual is authorized 35 hours a month of IHSS or WPCS and uses 5 BUPS hours in a month, then the individual still has 30 hours left of regular IHSS/WPCS hours to use during the rest of the month.  A provider cannot claim more hours working for a recipient than what the recipient is authorized to receive in a month.

How Many BUPS Hours can a Recipient Get?

• Non-Severely Impaired recipients are limited to a maximum of 80 BUPS hours each state fiscal year.
• Severely Impaired recipients may receive up to a maximum of 160 BUPS hours each state fiscal year if funding is available.

How Does the County Determine if a Recipient is Severely Impaired?

To qualify as “severely impaired” a recipient must need 20 hours or more per week in one or more areas of non-medical personal care services, meal preparation, meal clean up when the preparation of meals and feeding is required, and paramedical services.3 If you need less than 20 hours per week in these services, you are considered non-severely impaired.  The number of hours needed for each service can be found in your IHSS Notice of Action (NOA). Then you must add up all the hours you need in your NOA to determine if you need 20 or more hours of the services.

The Public Authority and County uses an information technology system called Case Management, Information and Payrolling System II (CMIPS II).  The program allows counties to manage the IHSS program and benefits in California.  The “BUP Hours Exception” box must be checked in the Public Authority/County CMIPS II system in order to receive up to 160 hours of BUPS services.  If a back-up provider is not paid at the correct rate, the County can go into CMIPS to make a correction so a provider can be paid at the correct rate.  In the future, CMIPS will not allow the County/Public Authority to assign a back-up provider to cases where all back-up services hours have been used up.4

BUPS Eligibility

A recipient is eligible for BUPS services if they have an urgent need:

• For back-up supportive services related to personal care services that cannot be met by an existing provider, OR
• Because the recipient is transitioning from an institution into the community and has not yet found a provider

An Urgent Need is defined as:

• Immediate and cannot be postponed until the provider is available to provide the need,
• Has a direct impact on the IHSS recipient,
• Delaying the need would potentially threaten the health and/or safety of the IHSS recipient, and
• May result in the need for emergency services and/or out-of-home placement.5

The BUPS program cannot require your friends and family volunteer to help you in place of BUPS services.

County Responsibilities

In managing the BUPS, the County or Public Authority must do the following:

• Recruit, enroll and keep a list of eligible BUPS providers.
• Respond to requests for and determine eligibility for BUPS services.
  • This includes whether back-up services are appropriate for individuals transitioning from an institution to home-based care.
• Provide recipients with referrals to at least one or more BUPS providers, if available, who align with the recipient’s preferences and needs.
  • The County cannot guarantee recipients will receive BUPS services if it is unable to locate an available provider for referral.
  • If a recipient does not use or terminates a back-up provider, the recipient will have to find and hire a non-BUPS provider.
• Assign a BUPS provider to recipient, with effective start and end date of service.6
• If an exception to the 80-hour annual limit is granted, tell recipients they have additional back-up provider hours available.7
• Enter information into CMIPS II.  CMIPS II allows the County or Public Authority to assign BUPS providers, track available and used BUPS hours, and grant exceptions.
• Operate the system at a minimum during normal operating hours Monday through Friday, excluding holidays.8

BUPS for Community Transitions

BUPS services can be used to assist individuals transitioning from facilities into the community.  This includes individuals transitioning out of incarceration.  For people transitioning to the community, counties or public authorities should determine:

• How much urgent care the recipient would need upon transition.
• Whether the use of the BUPS would be appropriate and safe considering the other resources and services that are in place,
• Whether the recipient would have difficulty managing a BUPS provider,
• Because services are temporary, the recipient may need the direct support of friends and/or family, until finding a permanent provider.

The BUPS program cannot require your friends and family volunteer to help you in place of BUPS services.

BUPS Denials Related to Transitioning Home

If you have been denied BUPS services needed to transition from a facility into your home, you may want to consider doing the following:

• Ask the facility/coordinating agency to notify the County or local Public Authority administering the BUPS program that you can be safely discharged with the help of a back-up provider.
• Explain to the County or Public Authority that you have a doctor approved discharge plan authorizing your discharge and the services you need to support BUPS eligibility.

Problems Accessing BUPS and Denials:

• You can contact your local County Board of Supervisor's Office about the lack of back-up providers on the County’s BUPS registry list.
• For BUPS denials and/or customer service or provider complaints, you can request a copy of the Public Authority’s grievance policy and file a grievance.
• You can call the County for help.
• You can call DRC’s intake line for assistance.

Back-Up Provider Pay and Eligibility

Under the BUPS, back-up providers receive a $2.00 per hour wage differential and may qualify for overtime.  To be eligible to work as a back-up provider, individuals must:

1. Not be convicted of any Tier 1 or 2 crime in the last 10 years,
   • Waivers cannot be used for BUPS providers.
2. Be legally allowed to work in the U.S.,
3. Be an enrolled provider within the IHSS program in the County or Public Authority in which the recipient resides and meet local requirements to be included on the local County or Public Authority BUPS registry.  An individual who has not completed all IHSS provider enrollment requirements cannot be listed on the BUPS registry.

Enrolling as a BUPS Provider

Individuals interested in becoming a back-up provider should contact the Public Authority (PA) or County in the County they wish to work in.

To find information about your County IHSS office or Public Authority, follow the links on pages 1 of this publication.

BUPS providers will be required to:

1. Complete and submit to the County and/or Public Authority the following:
   • IHSS Program Provider Enrollment Form (SOC 426),
   • IHSS Program Provider Enrollment Agreement (SOC 846), and
2. Complete a Department of Justice (DOJ) fingerprint criminal background check at an approved live scan facility.

Provider Workweek Limits

There are limits on the number of hours an IHSS/WPCS provider can work in a workweek.  The maximum weekly hours can be calculated by dividing a recipient’s monthly authorized hours by 4.  [Example: IHSS recipient with 100 hours per month ÷ 4 = 25 weekly maximum hours.]  This will give you the number of hours a provider can work per week AND determine the maximum allowable overtime hours.  General provider workweek limits are as follows:

One Provider → One Recipient

• A provider who works for one recipient cannot work more than 70 hours and 45 minutes per week for IHSS and/or WPCS combined.9

One Provider → Multiple Recipients

• A provider who works for multiple recipients cannot work more than 66 hours per week for IHSS and/or WPCS combined unless an exemption is granted.10

One Recipient → Multiple Providers

• A recipient with multiple providers can divide the maximum weekly hours among providers in any way the recipient sees fit.  Total hours worked by all providers combined in a week may NOT exceed the recipient’s maximum weekly hours.11

For more information about IHSS/WPCS workweek limits and exemptions and how to apply for them, you can review DRC publications, New Rules for IHSS: Overtime and Related Changes and Recent Changes to IHSS and WPCS Workweek Exemptions for Providers at: https://www.disabilityrightsca.org/resources/in-home-supportive-services-ihss.

You can also visit the California Department of Health Care Services Waiver Personal Care Services website at: https://www.dhcs.ca.gov/services/ltc/Pages/Personal-Care-Services-Overtime.aspx.

IHSS/WPCS Exemptions to Workweek Limits

The IHSS and WPCS program each have a process available to ask for an exemption from workweek limits.  The WPCS Workweek Overtime Exemption is separate from the IHSS Exemption from Workweek Limits.  Both exemptions will allow an IHSS/WPCS provider to work up to a maximum of 360 hours per month of combined IHSS and WPCS hours, not to exceed a recipient’s monthly authorized hours.  Providers only need one exemption, either an IHSS or WPCS Overtime Exemption, to be approved to work up to 360 hours per month.  They do not need to have both exemptions.  Providers who are granted a “Workweek Limit Exemption” are limited to a maximum of 90 hours per workweek, not to exceed 360 hours per month.

For more information about the IHSS Exemption for workweek limits you can review DRC’s publication entitled, Recent Changes to IHSS and WPCS Workweek Exemptions for Providers at: https://www.disabilityrightsca.org/publications/recent-changes-to-in-home-supportive-services-ihss-and-waiver-personal-care-services. You can also obtain information about the WPCS Workweek Overtime Exemption online at: https://www.dhcs.ca.gov/services/ltc/Pages/Personal-Care-Services-Overtime.aspx.

BUPS Exemptions to Workweek Limits

The IHSS program sends recipients (SOC 2271A) and providers (SOC 2271) letters with information on the Maximum Weekly Hours a provider can work.  If a recipient with multiple providers needs to use BUPS services, a temporary exemption to provider workweek limits may be approved for one of the other regular providers to work as a back-up provider instead of using a BUPS provider as follows:

One Provider → Multiple Recipients

• A recipient can assign hours to another provider without requesting County approval for a temporary “Work Week Limit” exemption as long as the hours worked by the provider do not cause the provider to work more than 66 hours in a workweek.12

Multiple Providers → One Recipient

• A recipient can assign hours to another provider without requesting County approval for a temporary “Work Week Limit" exemption as long as the hours worked by the provider do not cause the provider to work more than the recipient’s weekly maximum hours.13

If the recipient chooses a back-up provider who is not part of the BUPS, the back-up provider is not eligible for the $2.00 per hour wage differential.

Requesting BUPS Exemptions to Workweek Limits

In general, a provider who works more hours in a workweek than the recipient’s maximum weekly hours cannot do so without County approval.  Recipients and providers should contact the Public Authority or County as soon as possible if a temporary exemption from workweek limits is needed.  If a violation is received due to being unable to reach the County or make a request ahead of time, the provider should contact the County to have incurred violations removed. 14

How to get More Information About Your Rights

If you have a question about your legal rights:

• Call DRC’s intake line at: 1-800-776-5746.
• Call DRC’s Office of Clients’ Rights Advocacy (OCRA) at:
  • Northern California 1-800-390-7032 (TTY 877-669-6023)
  • Southern California 1-866-833-6712 (TTY 877-669-6023)

IHSS Self-Advocacy Resources

DRC IHSS Self-Advocacy Publications:
https://www.disabilityrightsca.org/publications/in-home-supportive-services-ihss

In-Home Supportive Services (IHSS): A Guide for Advocates:
https://www.disabilityrightsca.org/publications/in-home-supportive-services-ihss-advocates-manual

• 1. All County Letter (ACL) 22-65
• 2. ACL 22-65
• 3. Manual of Policies and Procedures (MPP) 30-701(s)(1)
• 4. ACL 22-105
• 5. ACL 22-65 & 16-01
• 6. ACL 22-105
• 7. ACL 22-105
• 8. ACL 22-65
• 9. Welfare and Institutions Code § 12300.4
• 10. Welfare and Institutions Code §§ 12300.4, 12301.1
• 11. ACL 16-01
• 12. ACL 22-65
• 13. ACL 22-65
• 14. ACL 18-54