COVID-19 (Coronavirus) - Tips for Getting Help at Home and IHSS Program Changes

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COVID-19 (Coronavirus) - Tips for Getting Help at Home and IHSS Program Changes

This information is for people who need help at home and get In-Home Supportive Services (IHSS).

This information is for people who need help at home and get In-Home Supportive Services (IHSS).

We will update this flyer on an ongoing basis as we get more information.

In this fact sheet, you will learn about:

  • IHSS Overview
  • Making a Back-Up Plan
  • Finding Backup IHSS workers
  • COVID-19 Changes Affecting IHSS Applicants, Recipients and Providers
  • Other COVID-19 IHSS Changes
  • IHSS Adverse Actions and Hearings
  • IHSS Advocacy Resources.

Overview - What is IHSS?

IHSS is a Statewide program that provides home care services to help eligible people with disabilities remain in their own homes.  IHSS provides help with:

  • Domestic and Related Services: meal preparation/clean-up, domestic services (house cleaning), laundry, food shopping, and other shopping errands.
  • Personal Care Services/Non–Medical Care: respiration (breathing), bowel/bladder care, feeding, bed baths, dressing, menstrual care, ambulation (walking/getting in/out of cars), transfers (in/out of bed or on/off seats), bathing/oral hygiene/grooming, rubbing skin/repositioning, help with prosthesis/medi-sets.
  • Paramedical Tasks: assistance with taking medications, injections, catheters, digital stimulation bowel program, suctioning, suppositories, colostomy irrigation and other activities requiring judgement based on training by a licensed health care professional.
  • Protective Supervision: monitoring persons with cognitive or mental impairments/illness to prevent injury.
  • Accompaniment: to medical appointments and other places you get other services in place of IHSS.

IHSS tells people if an application is approved or denied, what services a recipient can get, and the amount of time approved for each service by providing an IHSS Notice of Action (NOA). Click here to see what an IHSS NOA form looks like. The IHSS NOA also provides information about deadlines for appealing if you disagree with the county. Here is where you can find more information about requesting a hearing: https://www.cdss.ca.gov/hearing-requests .

During the Covid-19 pandemic, some IHSS rules have temporarily changed. You can find COVID-19 All County Letters (ACLs) referred to in this publication here: https://www.cdss.ca.gov/inforesources/letters-regulations/letters-and-n… .

Making a Backup Plan

Make a backup plan now. Here are tips:

  1. List things you need, like medication, medical equipment, service animals, and support services.
  2. Think about ways to meet your needs if there are no services.
  3. Here is a sheet to help you create your own backup plan - https://www.cdss.ca.gov/Portals/9/IHSS/Emergency/Personal-Emergency-Pla… .

Your emergency backup plan needs to look at how your home care needs will be met if your IHSS provider or providers become unavailable because of COVID-19 or for any other reason.

You may have already planned for an emergency with your social worker during your assessment. Look at your assessment paperwork or call the county to get a copy of it. Here is a list of social services offices: https://www.cdss.ca.gov/county-offices .

If you get services through a different agency, call that agency for more information. For example, if you also receive Waiver Personal Care Services (WPCS), then you can call your waiver agency or the Department of Health Care Services (DHCS) for more information.

This is also a good time to call your health plan and find out what services are covered and how to get them during an emergency.

Information about power outages and what is available is here: https://www.disabilityrightsca.org/publications/electric-utility-power-…

Finding Emergency Backup IHSS Providers

Counties have been told to create a backup IHSS provider system. The emergency backup IHSS provider program and an additional $2.00 per hour for providers is available now through December 31, 2021.1

You can get an emergency backup IHSS provider when your regular IHSS provider cannot work because of COVID-19. Contact your IHSS county office for more information about the IHSS emergency backup system in your area. Here is a link for IHSS county offices: https://www.cdss.ca.gov/inforesources/county-ihss-offices .

If you get services from a family member, talk to your family about backup IHSS provider plans.

Initial Assessments for IHSS Applicants

In general, most IHSS assessments will be done by phone or by videoconference through the end of the COVID-19 Public Health Emergency.2 Initial assessments are part of the application process. This section discusses options counties have for conducting initial assessments done as part of the IHSS application process during the COVID-19 public health emergency.

Assessments Basic Rule

Counties must conduct an in-home face-to-face assessment before authorizing IHSS services. The in-home face-to-face assessment is often called a “home visit.”  A “home visit” or “assessment” is part of the IHSS “initial assessment” and “reassessment” process.

COVID-19 Initial Assessments

Option 1: Remote IHSS Assessment

Counties may conduct initial assessments via video call (e.g. Skype or FaceTime) for IHSS applicants if the applicant or anyone in the household has been exposed to, presents symptoms of, or tests positive for COVID-19. Before scheduling an initial assessment, counties will ask IHSS applicants if anyone in the household has been exposed to, presents symptoms of, or tests positive for COVID-19. If so, the assessment will be conducted by phone or video conference. Counties can conduct assessments by phone or video conference until the end of the COVID-19 Public Health Emergency.

Option 2: Face-to-Face IHSS Assessments

Counties will conduct a face-to-face assessment in an applicant’s home as long as the applicant or anyone in the household has NOT been exposed to, presents symptoms of, or tests positive for COVID-19.  Before conducting a face-to-face assessments/home visit, counties should continue to collect as much information as possible over the phone in order to reduce the amount of time spent in applicant’s home. IHSS social workers will ask if you or anyone in your family has been exposed to COVID-19 before coming to your home. If, so the IHSS social worker will conduct the assessment by phone or video conference.

During a face-to-face assessment/home visit, the IHSS social worker must take precautions recommended by public health agencies. This includes maintaining a six-foot distance between you and other people in your home and using Personal Protective Equipment, when needed.  Social workers who have been exposed to, present symptoms of, or test positive for COVID-19 may not complete a face-to-face assessment in your home.

Reassessments

Annual Reassessment Basic Rule

Normally, counties reassess IHSS recipients every year by conducting an in-home face-to-face assessment.

COVID-19 Annual Reassessments

Counties have begun doing in-person reassessments. Counties can conduct reassessments, as needed, by video conference until the end of the COVID-19 Public Health Emergency.  The county will decide what IHSS services a recipient needs based on the completed assessment and IHSS program rules.

IHSS Forms for Applications, Initial Assessments and Reassessments

Health Care Certification

IHSS applicants must get a Health Care Certification (SOC 873) form from their doctor and give it to the IHSS program before IHSS services can be provided. Right now, you can get IHSS without the SOC 873 form.

Here is how it will work.  If you cannot get your doctor to fill in the SOC 873 form because of COVID-19, you can get up to 90 days to submit a SOC 873 form to IHSS.  This rule will remain in effect until September 30, 2021.

When doing this, first the county will give you IHSS services and 45 days for the SOC 873 form to be completed and returned.  If you need more time, you should call county and ask for another 45 days. You should explain to the county why your doctor cannot complete the SOC 873 form yet.

We recommend that you set up an appointment with your doctor to discuss your need for IHSS and the Health Care Certification form completed by your doctor in order to get IHSS services.  If your doctor refuses to fill out the form, you can file a written grievance with your Medi-Cal managed care plan.  Your Medi-Cal managed care plan has a responsibility to help you as an enrollee qualify for other needed Medi-Cal services including IHSS.

Other IHSS Forms During an Assessment by Telephone or Video Conference

The county normally collects signed forms it needs in order to process an IHSS application and authorize services during initial in-home assessments and reassessments.  When the county conducts an assessment by phone or video conference it may allow IHSS applicants, recipients and authorized representatives to self-attest to forms needed in order to process an application and authorize services.  An individual who self-attests to information in a form is verbally agreeing with the information in the form and that it is true.  The county is required to go over and document all forms self-attested to in the recipient’s IHSS assessment case notes.  This rule will remain in effect until the end of the state emergency in California.

The forms listed below must have an original signature:

  • Request for Order and Consent – Paramedical Services (SOC 321)
  • IHSS Designation of Authorized Representative (SOC 839)
  • IHSS Recipient’s Request for Provider Waiver (SOC 862)

IHSS Forms During an In-Home Assessment

The county is required to get the signed forms it needs during an in-person initial assessment or at the next annual in-person reassessment.

IHSS Services Because of Loss of Alternative Resources

Alternative resources are basically IHSS services provided outside the IHSS program.  Alternative resources can reduce IHSS hours.  Some people may receive alternative resources through school or a day program, such as Community Based Adult Services. You may get alternative resources from a person as well. You may be getting services through an alternative resource and may not know it.

Contact your social worker if you need additional IHSS hours because alternative resources like school or daycare are not available. If your IHSS social worker does not call you back, you can call the main IHSS office and ask for help with getting a call back or help through another county worker. If you still are unable to get help, you can call your local county supervisor’s office for help with getting the worker to respond to your calls. If you cannot reach your worker or your request is denied, you should document the request, and adjust your hours. You should also request a hearing to dispute the denial.

Follow these steps to find which alternative resources you are no longer receiving and what additional IHSS services you may need:

  1. Identify the alternative resource (day program, school, person, CBAS, regional center program/services, etc.) you are no longer attending.
  2. Identify IHSS tasks reduced in your NOA because of alternative resources.  This is under the column “SERVICES YOU REFUSED OR YOU GET FROM OTHERS”, because you get services from an alternative resource.
  3. Identify IHSS tasks you now need help with because of an elimination of an alternative resource.  This should include both alternative resources identified in your IHSS NOA and alternative resources the county did not identify.

Some examples of IHSS tasks you may need help with because of the loss of an alternative resource include: assistance with feeding, meal prep/cleanup, diaper changes, assistance with ambulation, help with prosthesis, increased unmet need for those who need protective supervision, assistance with medications, paramedical services (such as range of motion exercises no longer being provided by a physical therapist (PT) or IHSS tasks provided as part of the receipt of nursing services which you are no longer getting due to a nursing shortage), time your IHSS provider spends ordering your food online because you can no longer shop for yourself because paratransit is no longer available to you, etc.

Remember, counties may not always identify and document alternative resources during an assessment and in your IHSS NOA so it is important that you advocate for yourself.

It is also a good idea to document your request for the additional time and provide an explanation as to why more time is needed.  A sample letter of what a request for more time due to the elimination of alternative resources might look like is below.

COVID-19 Vaccine Medical Accompaniment

If you need help from your IHSS provider to get the COVID-19 vaccine and have authorized time for Medical Accompaniment, you can use this time to get vaccinated.

If you need additional time to get vaccinated or you are not authorized to receive time for accompaniment to medical appointments but you need help from your provider to get the COVID-19 vaccine, you can get up to four hours (two hours for each vaccine) authorized for your IHSS care provider to accompany you.

To be paid, IHSS providers must complete the Vaccine Medical Accompaniment Claim form and have the recipient sign the form. The form must be submitted to the County IHSS office.  Here is where you can get the claim form:

https://www.cdss.ca.gov/Portals/9/IHSS/Emergency/Vaccine%20Medical%20Ac…; If you or your provider have questions, please contact your County IHSS office.

IHSS Provider Enrollment Process

If you know someone who wants to be a an IHSS or backup IHSS provider, they can become one right now.  Here is information on becoming an IHSS provider: https://www.cdss.ca.gov/inforesources/ihss/ihss-providers/how-to-become…; Individuals who want to become a provider can also contact their county IHSS office or county Public Authority for information about the provider enrollment process.

Provider Enrollment Process Basic Requirements

In order to be a paid IHSS provider, individuals must:

  • Attend an in-person enrollment orientation
  • Sign a Provider Enrollment Agreement Form SOC 846
  • Present in-person original documents verifying identity.
  • Undergo fingerprinting at an approved live scan facility and complete a Department of Justice (DOJ) background check.
  • Sign a Provider Enrollment Form SOC 426

COVID-19 Orientations, Forms and Identification

New IHSS providers are required to attend an orientation either in-person or online and sign a Provider Enrollment Agreement Form SOC 846 as part of the provider enrollment process.  You can find Form SOC 846 here: https://www.cdss.ca.gov/cdssweb/entres/forms/english/soc846.pdf.  Providers who completed the orientation and received more time to complete and submit the SOC 846 form have until September 30, 2021 to complete this part of the enrollment process.

In counties where the IHSS and public authority offices are closed, photocopies of original provider identification documents and the SOC 426 can also be submitted by mail or fax until the end of the state emergency in California. Providers who gave the county photocopies of original identification documents will not have to present their original documentation after the state of emergency ends in California.

IHSS Providers can be enrolled while county waits to receive identifying documents and providers complete the orientation process.  IHSS recipients are still required to complete Recipient Designation of Provider Form SOC 426A.

As of October 1, 2021, new providers who submit a Provider Enrollment Agreement Form SOC 846 as part of the IHSS provider enrollment process must present original identification documents.  The county or Public Authority will photocopy the documents and return them to the applicant provider.

COVID-19 IHSS Provider Sick Leave

IHSS providers can get COVID-19 sick leave through March 31, 2021.  COVID-19 sick leave does not affect existing IHSS paid leave.

  • Providers who work 40 hours or more per week can get 80 hours of sick leave.
  • Providers who work less than 40 hours per week can get the average number of hours worked over a two-week period.

COVID-19 sick leave is available to employees who cannot work for one of the following reasons:

  • Provider is in quarantine,
  • Provider has been told by doctor to quarantine,
  • Provider has symptoms and is seeking doctor’s help,
  • Provider is caring for person who is in quarantine or has been told by doctor to quarantine,
  • Provider is caring for his/her child whose school or child care has closed or childcare provider is not available because of COVID-19 or, has another COVID-19 related problem.

To claim sick time, providers must complete a COVID-19 Provider Sick Leave (TEMP 3021) Form: https://www.cdss.ca.gov/Portals/9/Additional-Resources/Forms-and-Brochu…

COVID-19 State Supplemental Sick Leave

IHSS providers can get State Supplemental Paid Sick Leave through September 30, 2021.

  • Providers who work an average of 160 hours per month during the last 6 months can get up to 80 hours of sick leave.
  • Providers who work less than 160 hours per month during the last 6 months can get the average number of hours worked over a two-week period.

COVID-19 State Supplemental Sick leave is available to employees who cannot work for one of the following reasons:

  • Provider is in quarantine,
  • Provider has been told by doctor to quarantine,
  • Provider has symptoms and is seeking doctor’s help,
  • Provider has symptoms which prevent the provider from working,
  • Provider is getting a vaccine shot
  • Provider is caring for a family member who is in quarantine or has been told by doctor to quarantine,
  • Provider is caring for his/her child whose school or child care has closed or childcare provider is not available because of COVID-19 or, has another COVID-19 related problem.

COVID-19 Provider Sick Leave (TEMP 3021) Form has been revised so a provider can request either IHSS Provider Sick Leave or State Supplemental Sick Leave.

COVID-19 Essential Protective Gear (EPG) for IHSS Providers and Recipients

IHSS Public Authority offices are now distributing face masks and gloves to any IHSS providers and recipients who request it.

Recipients and providers should contact the public authority in your county to request EPG: https://capaihss.org/contact-us/contact-ihss-in-your-county/.

No IHSS Overtime Violations through August 31, 2020

Counties must allow IHSS providers more flexibility to provide needed services.  This gives you flexibility to assign hours to providers for services that are a “critical need.”  If your provider gets an overtime violation because your provider was providing you with IHSS services that are a “critical need,” your provider’s violation can be removed through August 31, 2020. 

As of September 1, 2020, violations for exceeding overtime and travel time limits will begin again. Going forward, counties should use the process in ACL 16-46 to determine if requests to rescind overtime and travel time violations for services that are necessary because of COVID-19 can be granted.

Counties can override overtime violations if:

  1. the additional hours are necessary to meet an unanticipated need;
  2. the additional hours are related to an immediate need that could not be postponed until a backup provider arrives; and
  3. the additional hours are related to a need that would have a direct impact on the IHSS recipient and would have been needed to ensure their health or safety.

COVID-19 may require IHSS that providers to work more overtime, in which case an exception can be granted.  Reasons for an exception would be the same as the exemption reasons above. Counties should consider these situations when determining whether to override an overtime or travel time violation.  If you think you need an exception, you should request one from your county worker.

IHSS Adverse Actions

IHSS applicants and recipients have 90 days to appeal a change in services or decision with which they disagree by asking for a hearing. If you ask for a hearing before the change is supposed to happen your IHSS service continue at the same level until the outcome of your hearing. Here is how you can ask for a hearing: https://www.cdss.ca.gov/hearing-requests

IHSS Fair Hearings

The state is only holding hearings by phone or video conferencing until further notice: https://www.cdss.ca.gov/inforesources/appeals-case-management-system.

  • IHSS recipients and applicants have a right to a hearing to contest an IHSS denial or reduction in services.
  • Some in-person hearing requests will be postponed until in-person hearings are allowed again.  Postponements for in-person hearings are being granted on a case-by-case basis.  If the recipient is entitled to aid paid pending, aid paid pending will continue until the outcome of the in-person hearing in cases where postponements are granted.
  • If you request a hearing by video conference, you will need access to a telephone, computer, or tablet.
  • If you do not have a telephone, computer, or tablet, but want a video or telephone hearing, you can go to your county office to use their telephone or video equipment.
  • You can find more information about hearings online: https://www.cdss.ca.gov/hearing-requests

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) if you are a Regional Center client 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

Sample Letter - Requesting More IHSS Services Because of a Loss of Alternative Resources

Date

County IHSS Program
Address or Email:
Attention: IHSS Social Worker

Name of IHSS Recipient:
Case No.:

Dear IHSS Social Worker:

I am sending you this letter to request approval and to document my child’s need for more IHSS hours because of a loss of alternative resources.  I am my child’s parent provider.

Before Covid-19 social distancing requirements, my child had been attending a school program for five hours during the day.  My child’s school program is no longer available because of COVID-19.

At my child’s school program, my child received assistance with the following IHSS tasks:

  1. XX hours: Meal preparation, feeding and meal clean up.  Lunch which takes approximately 20 minutes to complete all tasks.
  2. XX hours: Paramedical services.  Physical therapy (PT) session at school twice per week for a ½ hour each session.  I have been training by my child’s PT to provide my child with this service at home.  I am in the process of obtaining an SOC 321 form completed by child’s PT.
  3. XX hours: Assistance with diaper changes approximately twice per day.  Each diaper change takes approximately 15 minutes to complete.
  4. XX hours: Repositioning in wheelchair.  My child needs to be repositioned in their wheelchair once per hour about five times per day.  It takes about 3 minutes each time they are repositioned.

Since my child’s school program ended on XX, 2020, I have been providing my child with the IHSS tasks above.  I am asking that IHSS grant my child approval of the XX hours of IHSS tasks my child now needs because of COVID-19 related loss of their educational program as required in All County Letter 20-26, https://www.cdss.ca.gov/Portals/9/Additional-Resources/Letters-and-Noti…; This is in addition to the other IHSS services they are currently getting.

Thank you,
Parent

  • 1. All County Letter (ACL) No. 21-79
  • 2. ACL 21-79

 

 

Click links below for a downloadable version.