In-Home Supportive Services
One must be over 65 years of age, or disabled, or blind to be eligible for an I.H.S.S. CareReceiver, and meet the financial limitation requirements. An S.S.I. recipient may qualify for I.H.S.S. services too, but one need not receive an S.S.I. check in order to qualify.
I.H.S.S. is a very large program statewide. Provided in all 58 Counties, with over 194,000 people currently receiving services monthly, with more than $700,000,000/year is paid out for such services, at the minimum wage rate. The Care Receiver is aided by the care, and the Care Giver earns taxable income from the payment.
I.H.S.S. funds are paid by the 58 Counties so that a person who is over 65 years of age, or disabled, or blind, may remain at home with assistance for the number of hours needed for personal needs, such as bathing, bladder care, dressing, grooming, personal care, and paramedic services and/or meal preparation, laundry, grocery shopping, cooking, and cleaning. Such home-care is less expensive than institutionalization.
To maintain independence and enhance personal productivity, government programs provide assistance and care coordination for:
Medical and wound care,
Assistive technology (AT)
Other technical assistance
I.H.S.S. is a 3-party system: The payment is between the County and the Applicant/CareReceiver/Employer. The employment relationship is solely between the Applicant/CareReceiver/Employer and their independent Employee, who is someone willing to accept Minimum Wage employment. Keeping the employment relationship independent from the payment relationship is for purposes of autonomy.
The Applicant/Employer may hire or fire the Employee at will. The County does not supply the Employee. The homebound Applicant/Employer must locate their own Employee. Often a County will provide the names of agencies, but without endorsement of any agency or staff. Sometimes there is difficulty in locating a qualified Employee.
The payor County determines the number of hours, using the disability documentation as a base for application of government statistics about what kinds of services are needed, and how much time is needed to provide such a service. The County pays the Applicant/CareReceiver/Employer for those hours, so that the Employer has the ability to pay the Employee..
The County Social Worker interviews the I.H.S.S. Applicant who will be the CareReceiver/Employer. The County Social Worker reviews relevant medical documentation, and makes the determination of the number of hours per week that services are needed. The County pays that sum at the minimum wage rate to the Applicant/CareReceiver/Employer, who has the same mandatory duties as any other employer of any other Household Employee: to file the appropriate federal and state tax and employment records. (Such record-keeping and filing is beyond the scope of this article, but classes may be taught at the local Senior Center, or assistance may be available on designated days from volunteers, or other local resources recommended by the Geriatric Care Manager.)
The Applicant/CareReceiver/Employer pays the Employee the minimum wage plus the additional amount needed for taxes, which is figured into the County’s calculations.
Failure to pay the Employee does not involve the County, but is a theft, can be reported to the police by the Employee, and if not handled shortly, can be cause for a tax fraud issue later, with prosecution.
A different problem arises when the Employer pays the Employee, but the Employee fails to return. That too is a theft, but of a failure to provide services, with the varying consequences depending on the many other demands being then made on the slim resources of the local constabulary.
A family member can be paid for I.H.S.S. services of personal care, only, not for family work. If the Employee is a family member, I.H.S.S. will not pay for family-type functions of cooking and cleaning which benefit the household, as such services are expected to be provided by any co-tenant family member occupying the home. House-work is part of being a family; the family member would be cooking and cleaning for himself. But personal care tasks are another matter: I.H.S.S. will pay a family member to perform personal care tasks, such as bathing, bladder care, dressing, grooming and personal items.
Consequently the total number of hours allowed for a family member will be less than the total number of hours allowed for a non-family member as a caregiver. The risk of theft by a stranger may be reduced, but the risk of theft itself may not be reduced, depending on the family dynamics.