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Understanding and Advocating for
IN HOME SUPPORTIVE SERVICES(IHSS)
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JAMES HUYCKPUBLIC BENEFITS CONSULTANT/ADVOCATE
----------------------------------------------------------------Terry M. Magady, Esq.The Elder Law Center
[email protected](Office) ((310) 478-6543 (Cell) (310) 490-9136
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In Home Supportive Services (IHSS)
• Extremely important benefit to persons with disabilities • Primary statewide program designed to
provide nonmedical personal care and other in-home services in order to allow persons with disabilities to remain in own home• The person with a disability must be unable
to perform the services for himself or herself, and be unable to remain safely in the home unless the services are provided• IHSS is a Medi-Cal funded program
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IHSS Process
• Contact IHSS to apply• Health Care Certification form• IHSS Assessment• Time for task• County Guidelines
• Notice of Action• Appeal (if necessary)
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Application• Phone call to local IHSS agency
• Question regarding Age• No age requirement
• Application over the phone• Health Care Certification form will be sent out
• must be returned within 45 days
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IHSS Assessment
•Assessment Scheduled once Health Care Certification form is returned•Assessment held in home with an IHSS
Social Worker•Have heard stories of very short
assessment• Should take at least 1 to 2 hours•Most items – time for task
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County Guidelines
• There are time guidelines for some service categories • Apply if there is no reason for an exception based on
the guidelines. • Guidelines can only be applied based on the recipient’s
individual level of need and to the extent necessary to ensure his/her health and safety. • When a recipient’s need requires an exception for more
or less time than the time guideline, the need for more or less time must be documented in the case record.
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IHSS SERVICES
• Domestic services, such as:• sweeping • vacuuming • taking out the garbage • wheelchair cleaning and battery recharging • changing bed linens
• Related services, such as:• meal preparation • cleanup • laundry• shopping
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IHSS Services• Personal care services, such as:
• feeding, bathing• grooming,• dressing • bowel and bladder care• help with medications
• Transportation to medical appointments or alternative sources of services like day programs
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Paramedical Services
• injections • breathing treatments, nebulizer • catheter changes• skin and wound care if there is a decubitus ulcer • suctioning through a tracheotomy or through the nose and
mouth • including tracheal suctioning• bowel program • insertion of suppositories or administration of an enema
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Protective SupervisionService for people who, due to a mental impairment or mental illness, need to be observed 24 hours per day to protect them from injuries, hazards or accidents.
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Protective SupervisionIndividuals eligible for Protective Supervision must have:
A “mental impairment” or “mental illness” that causes functional limitations in:• Memory (e.g. forgetting things, people, places, to start or finish a task,
etc.)
• Orientation (e.g. inability to recognize and adapt to time, people, places, environment, surroundings etc., needed to live and complete tasks
• Judgment (e.g. making decisions which put the individuals health and/or safety at risk)
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WORKSHEET – PREPARE IN ADVANCE
California’s protection & advocacy system916-504-5800 in Northern CA or 213-213-8000 in Southern CA. TTY 800-719-5798.
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When to Appeal • If you are challenging a reduction in hours or a
termination of services, you must request a fair hearing within the 10 days, before the notice of action is effective, in order to continue receiving all your hours until the hearing is over.
• A request for hearing MUST be filed within 90 calendar days after the date of the county action or inaction. However, if the request is filed after the 10-day period mentioned above, the benefits will NOT continue pending the hearing. If you win at hearing, the judge may order back payment.
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How to Request an Appeal• Fill out the back of the Notice of Action form and send to the address indicated,
or
• Send a letter to:
IHSS Fair Hearing State Hearings Division Department of Social Services
744 P Street, Mail Stop 9-17-37 Sacramento, CA 95814
• It is best to file a written request.
• You can fax the letter (in addition to mailing it) to 916-651-5210 or 916-651-2789.
or
• Call the toll free number at 800-743-8525 to request a fair hearing.
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Regarding Appeals• County Representative will make contact prior to the
hearing• Attempt to settle
• May call about "conditional withdrawal" so that a new assessment can be done. • If you agree to a conditional withdrawal of your appeal,
you have a right to have the hearing rescheduled if you disagree with the new assessment or a decision not to authorize retroactive benefits.
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Appeal Hearing
• County Representative will sometimes meet just prior to going into the hearing
• Have had cases resolved in the “hallway”
• Bring applicant to the hearing if useful to make the case
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Questions?