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OCRA ORIENTATION

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OCRA ORIENTATION. IN HOME SUPPORTIVE SERVICES. TWO PROGRAMS.

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ocra orientation

OCRA ORIENTATION

IN HOME SUPPORTIVE SERVICES

two programs
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
RESIDUAL PROGRAM
  • 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.
slide4
PCSP
  • 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
INDEPENDENCE PLUS DEMONSTRATION WAIVER
  • 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
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
pcsp laws
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
service authorization
SERVICE AUTHORIZATION
  • 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 authorization9
SERVICE AUTHORIZATION
  • 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
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
all county letters11
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