BILL ANALYSIS Ó
SENATE COMMITTEE ON HUMAN SERVICES
Senator McGuire, Chair
2015 - 2016 Regular
Bill No: AB 1797
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|Author: |Lackey |
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|Version: |February 25, 2016 |Hearing | June 14, 2016 |
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|Urgency: |No |Fiscal: |Yes |
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|Consultant|Taryn Smith |
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Subject: In-home supportive services: application
SUMMARY
This bill authorizes a person to apply for in-home supportive
services (IHSS) in person or through electronic means and
requires the county, if an application is filed through
electronic means, to provide the applicant a confirmation
number, as specified. This bill also requires the county to
process an application for IHSS within 30 days.
ABSTRACT
Existing law:
1) Establishes the IHSS program to provide defined
supportive services for aged, blind, or disabled persons
who are unable to perform the tasks themselves and who
cannot safely remain in their homes unless such services
are provided. Those supportive services include, but are
not limited to, domestic services, heavy cleaning, personal
care services, and accompaniment during travel to
health-related appointments or to alternative resource
sites, yard hazard abatement, protective supervision, and
paramedical services, as defined. (WIC 12300 et seq.)
2) Provides that a recipient who is authorized to receive
IHSS supportive services shall direct those authorized
services, and the authorized services shall be performed by
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a provider or providers within a workweek and in a manner
that complies with the requirements, as specified. (WIC
12300.4)
3) Establishes county authority to contract with a
nonprofit consortium or a public authority for the delivery
of IHSS supportive services. Requires those nonprofit
consortia and public authorities to establish a registry in
order to assist IHSS recipients with hiring providers, and
to investigate the background and qualifications of
potential providers, as specified. (WIC 12301.6)
4) Requires that the application for IHSS services shall
contain a notice to the recipient that his or her provider
or providers will be given written notice of the
recipient's authorized services and full number of services
hours allotted to the recipient. The application shall
inform recipients of the Medi-Cal toll-free telephone fraud
hotline and Internet Web site for reporting suspected fraud
or abuse. (WIC 12301.15)
This bill:
1) Permits a person to apply for IHSS services in person or
through electronic means, including, but not limited to, by
telephone.
2) Requires that, if an application for IHSS services is
filed through electronic means, the county shall provide
the applicant a confirmation number to serve as
documentation that the application was filed.
3) Permits the county to use the applicant's case number as
the required confirmation number.
4) Requires the county to process an application for IHSS
services within 30 days of receipt of the completed
application.
FISCAL IMPACT
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According to an analysis prepared by Assembly Appropriations
Committee, there would be a negligible cost to counties.
Because the bill is clear that case numbers, which are
automatically generated through the existing application
process, can be given as confirmation numbers the county costs
would not likely to be significant enough to file a claim for a
state mandated reimbursement. Further, the 30 day processing
period required in the bill is currently required by regulation.
BACKGROUND AND DISCUSSION
Purpose of the bill:
According to the author, many IHSS applications that are filed
telephonically have been getting lost in the system, and
applicants are not told how to best track their applications.
The author states that AB 1797 would provide that any person who
needs in-home services to avoid being placed in a nursing home
shall have the right to apply for services in-person or by
telephone and receive a confirmation number for the application
when applying by phone. AB 1797 would allow the counties to use
the currently issued case number as a confirmation number.
Furthermore, the bill would require that IHSS applications be
acted upon within 30 days.
In Home Support Services
The IHSS program, which is administered by the California
Department of Social Services (CDSS) provides in-home services
for low-income aged, blind and disabled individuals who are
unable to perform the tasks themselves and who cannot safely
remain in their homes unless these services are provided. IHSS
recipients need those services in order to avoid out-of-home
care.
IHSS services may include domestic and related services, like
housework, meal preparation, laundry and shopping; personal care
services; accompaniment to medical appointments; protective
supervision for the mentally-impaired recipients who may place
themselves at risk for injury; and hazard or accident and
paramedical services when directed by a physician.
Potential IHSS recipients must apply for IHSS services with the
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county in which they reside. Often, these applications are
initiated over the phone, but they can be completed in person at
a county IHSS office. Either way, county workers assist with
completing the application and enter information directly into
the Case Management, Information and Pay rolling System (CMIPS),
which tracks case information and processes payments for IHSS.
CMIPS generates a case number.
After the initial application is completed, a county social
worker conducts a home visit to determine the type of services
needed and the number of hours for each service. The county
considers medical condition, living arrangement, and any
resources that may already be available. The applicant also
must submit a Health Care Certification Form, which is completed
by the applicant's doctor, and certifies the need for IHSS. This
form must be completed before services can be authorized.
Once approved, the county notifies the IHSS recipient which
services have been approved, how much time is authorized for
each service, and how many total monthly hours have been
approved. IHSS recipients are responsible for hiring, firing,
directing and supervising their IHSS provider. These
responsibilities include some administrative duties, such as
scheduling and signing timesheets. However, the state handles
payroll via CMIPS.
Providers must complete an enrollment process, including
submitting fingerprints for a criminal background screening and
participating in an orientation prior to receiving payment for
services.
Approximately 464,000 Californians receive IHSS and about 99% of
recipients receive IHSS as a Medicaid benefit. There are
currently about 433,400 IHSS providers in the state.
Approximately 69 percent are relatives and about 50 percent are
live-in providers.
Related legislation:
Assembly Bill 19 (Evans, Chapter 17, Statutes of 2009) a human
services budget trailer bill, included a requirement that
applications for IHSS shall provide written notice of the
recipient's authorized services and full number of services
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hours allotted to the recipient, as specified.
COMMENTS
CDSS regulations already require that applications be processed
within 30 days of the date the application is complete.
Specifically, the regulations require that the application shall
be processed, including eligibility determination and needs
assessment, and that notice of action must be mailed no later
than 30 days following the date the written application is
completed. There is an exemption to the 30-day requirement when
a disability determination has not been received, as
specified.<1> Therefore, codifying a 30-day processing timeline
is consistent with current practices.
Additionally, CDSS issued All County Letter #12-36 which
requires the counties to issue a confirmation number to the IHSS
applicant. The letter reads, in part, "At the time the
application information is entered in either Legacy CMIPS or
CMIPS II, a case number will be assigned to the applicant.
Legacy counties, to the extent that current business practice
allows, and all CMIPS II counties shall provide the case number
to the applicant or their authorized representative before the
end of the telephone call during which the application is taken,
or before they leave the IHSS office so the applicant or their
authorized representative will be able to refer to the case
number in any communications with the county."
According to CDSS, most counties do not accept IHSS applications
in-person and none of the counties have an electronic means to
accept IHSS applications. The majority of IHSS applications are
initiated via telephone. As it currently reads, AB 1797
references electronic and in-person application processes which
are generally not available. Therefore, the following amendment
is suggested:
WIC 12301.16.
(a) A person may apply for in-home supportive services in person
or through electronic means, including, but not limited to, by
telephone. If an application is filed through electronic means,
Upon receipt of an application for in-home supportive services,
the county shall provide the applicant a confirmation number to
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<1> CDSS Manual of Policies and Procedures Section 30-759.2
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serve as documentation that the applicant filed an application
for in-home supportive services. The county may use the case
number as the confirmation number.
While these amendments acknowledge the fact that the technology
to apply online for IHSS does not exist, the committee
encourages the department to consider creating an online
platform that would modernize the application process and other
services to IHSS applicants, recipients and providers.
PRIOR VOTES
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|Assembly Floor: |79 - |
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|Assembly Appropriations Committee: |20 - |
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|Assembly Human Services Committee: |6 - |
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POSITIONS
Support:
Coalition of California Welfare Rights Organizations
(Sponsor)
AARP California
Bet Tzedek Legal services
California Advocates for Nursing Home Reform
Disability Rights California
Senior and Disability Action
The California Commission on Aging
The California In-Home Supportive Services Consumer
Alliance (CICA)
The Law Foundation of Silicon Valley
The Personal Assistance Services Council, the Los Angeles
County Public Authority
UDW/AFSCME Local 3930
Oppose:
None
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