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, so there are 3 participants in this system, instead of only 2.
This 3-party program (with an Employer, Employee and Payor) allows individuals needing personal assistance with the 5 ADL/s Activities of Daily Living to continue living at home without placement. I.H.S.S. enables a person over 65 years of age, or disabled, or blind, to remain at home with hourly-paid assistance based on the number of hours needed in fact for 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 less expensive monthly to the state than institutionalization would be.
The policy concept is to keep the EMPLOYMENT relationship separate from the PAYMENT relationship in order to maintain patient autonomy and prevent fraud, while still ensuring that payroll deductions (for UIB and DIB benefits for the Care Provider/Employee) with timely federal Social Security contributions. for details, please 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 must be able to provide the services daily, be willing to accept the Minimum Wage employment and submit their payroll records timely.
How is LA County involved? The County establishes the relationship 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 time estimates are inaccurate, so being prepared to be as specific as possible is helpful.
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.
In LA County to see the JOB BANK link on the website for PASCLA/Personal Assistance Council Los Angeles, look at http://www.pascla.org/ and for trainings, meetings and teleconferences.
Family members have family responsibilities already, so their payment system may differ from someone who lives alone. Grocery shopping, cooking, meal preparation, laundry, shopping, banking, or errands are family obligations which will NOT be paid by IHSS.
But a family member CAN be paid for I.H.S.S. services for PERSONAL CARE, not the family work. House-work is part of being a family, but personal care tasks are another matter: I.H.S.S. will pay a family member for personal care tasks, such as bathing, bladder care, dressing, grooming and personal items. The total number of hours paid for a family member may be less than the total number of hours allowed for a non-family member as a caregiver, so there may be differences in pay between two people who are providing the same services: one a family member and one not.
So 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/when the Employee fails to return, that is a theft by a failure to provide services.
Important to know and document the Care Plan and everyone SIGN it!