In-Home Supportive Services
Who is eligible? One must be over 65 years of age OR disabled OR blind to be eligible for as an I.H.S.S. CareReceiver/Employer AND meet the financial limitations. An S.S.I. recipient may qualify for I.H.S.S. services too. However, one need not receive an S.S.I. check in order to qualify for services with an SOC/Share Of Cost.
What is the program? I.H.S.S. is a statewide program statewide, provided in all 58 Counties in California. California pays the minimum wage rate for such services provided for the Care Receiver/Employer (who is aided by care needs being met at home) and the Care Giver/Care Provider/Employee who earns taxable income from the wages paid plus Community-based medical with California as Payor. There are 3 participants in this system: an Employer, Employee and Payor.
This program enables individuals who need personal assistance with the 5 ADL/s Activities of Daily Living to continue living at home without placement. The person must be over 65 years of age, or disabled, or blind. The hourly-paid assistance is based on the number of hours needed for the person’s personal needs: ADL’s/Actitivies of Daily Living, for eating, bathing, dressing, bladder care, and transfer (ex: bed to chair) for personal care]. Such home-care is a less expensive monthly outflow for the state than paying monthly for institutionalization.
For LA County, see http://www.pascla.org/ for the JOB BANK link and trainings, meetings and teleconferences on the website for PASCLA/Personal Assistance council Los Angeles.
For elsewhere in California, see http://www.cdss.ca.gov/In-Home-Supportive-Services for statewide information.
The County establishes the number of hours by interviewing the proposed CareReceiver/”Employer” about their personal needs. The County’s Eligibility Worker reviews relevant medical documentation, asks questions, and completes forms with checklists. Based on the responses provided by the proposed Care Receiver, the checklist documents the number of hours per week that services are needed. Sometimes the Receiver’s time estimates are inaccurate, so be prepared to be as specific as possible about what tasks are needed and how long such tasks take, and why.
The EMPLOYMENT relationship is separate from the PAYMENT relationship: this benefits the Care Receiver/Employer by maintaining patient autonomy (and choice) while preventing fraud, and ensures the Care Provider/Employee that payroll deductions (for UIB and DIB benefits) are being made and with timely federal Social Security contributions. For details, see Disability Rights California at http://www.disabilityrightsca.org/ which is California’s Protection & Advocacy program [at 1-800-776-5746]. The employment relationship is solely between the CareReceiver/”Employer” and their own chosen independent “Employee” who provides the daily services and is willing to accept the Minimum Wage employment and submit their payroll records timely.
The Care Receiver/Employer has the same mandatory Labor Law duties as any other Employer: to file federal and state tax and employment records and make payroll timely. But IHSS record-keeping and filing is beyond the ability of an ill, at-home CareReceiver/Employer. So these records and determinations are done instead by California.
The homebound CareReceiver/”Employer” must locate their own Employee.
The government does not supply the Employee. Sometimes a County may provide a list of agencies but without endorsement of any agency or staff. Sometimes an eligible CareReceiver/”Employer” may have difficulty in locating a qualified Employee. Sometimes local NPO agencies provide referrals or weekly posts about people able and willing to do the work.
A family member may be paid by I.H.S.S. for PERSONAL CARE services (such as bathing, bladder care, dressing, grooming and eating) but not for family responsibilities such as grocery shopping, cooking, meal preparation, laundry, shopping, banking, or errands, as these are household obligations.
As a result, a Family Member’s total number of hours’ paycheck may be less than a NON-Family Member’s total number of hours’ paycheck. Two different people providing the same services to two different CareReceivers will not be paid the same sum because they are not performing in the same situation when one is a family member and the other is not. However, both receive Community-based Medi-Cal and the risk of theft by a stranger may be reduced.
EmployER should not pay the EmployEE directly ~ or ‘tip’ the EmployEE. Doing so opens the door to elder abuse allegations and litigation. If the Employee fails to return, then a theft may have occurred (by the failure to provide services) so that a report should be made forthwith, to prevent fraud on the timesheets, so that the replacement CareGiver (from the JOB BANK) can be paid.
Bottom line: Critically important to know and document the Care Plan AND everyone SIGN on to it!